World Journal of Surgery

, Volume 35, Issue 5, pp 967–972

Laparoscopic Versus Single-Incision Cholecystectomy

  • Fatima Khambaty
  • Fred Brody
  • Khashayar Vaziri
  • Claire Edwards
Article

DOI: 10.1007/s00268-011-0998-6

Cite this article as:
Khambaty, F., Brody, F., Vaziri, K. et al. World J Surg (2011) 35: 967. doi:10.1007/s00268-011-0998-6

Abstract

Background

Although recent reports demonstrate large series of single-incision cholecystectomies, few articles compare single-incision data with traditional laparoscopic cholecystectomy (LC) data. This article compares a large series of single-incision cholecystectomies to a series of traditional LCs performed at an urban tertiary-care center.

Methods

A consecutive series of single-incision cholecystectomies was performed from August 2008 to March 2010. All cholecystectomies were attempted through a single incision on an intent-to-treat basis. Patient demographics, including height, weight, body mass index (BMI), pathologic diagnosis, ASA classification, operative time, complications, narcotic use, and length of stay (LOS), were recorded. Data for a matched cohort of patients undergoing a traditional four-port LC were gathered over a similar time period. Data were compared using a t test with a P < 0.05 for significance.

Results

Single-incision cholecystectomy was successful in 81 (76%) of 107 patients. The 26 (24%) converted cases showed a higher BMI (33.0 ± 8.7 vs. 28.4 ± 6.4 kg/m2, P < 0.05) and longer operative times (98.3 ± 33 vs. 76.1 ± 23 min, P < 0.003). Postoperatively, the converted patients had a longer LOS compared to that of the single-incision group (1.6 ± 1.0 vs. 1.1 ± 0.4 days, P = 0.02). Overall, the single-incision group had longer operative times compared to the four-port LC group (81.5 ± 28 vs. 69.1 ± 21 min, P < 0.004). However, after the tenth single-incision case, there was no difference in operative times. From a narcotic standpoint, the successful single-incision patients used significantly less narcotic versus the traditional LC group (20 ± 22.7 vs. 32.3 ± 31.2 mg, P = 0.02).

Conclusions

The data suggests that individuals with a BMI over 33 may not be candidates for single-incision cholecystectomy. Those patients that undergo a successful single-incision laparoscopic cholecystectomy require fewer narcotics postoperatively and have a shorter LOS. Although this data is intriguing, the overall utility of single-incision procedures requires more analysis and potentially randomized trials.

Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Fatima Khambaty
    • 1
  • Fred Brody
    • 1
  • Khashayar Vaziri
    • 1
  • Claire Edwards
    • 1
  1. 1.Department of SurgeryThe George Washington University Medical CenterWashingtonUSA

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