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Surgical Endoscopy

, Volume 30, Issue 10, pp 4389–4399 | Cite as

Single-incision laparoscopic cholecystectomy: does it work? A systematic review

  • Marco Maria Lirici
  • Simone Maria Tierno
  • Cecilia Ponzano
Article

Abstract

Background

Single-incision laparoscopic cholecystectomy (SILC) has been widely introduced into the clinical practice, but the real clinical benefits for patients still remain a matter of debate. We conducted a systematic review, according to the PRISMA guidelines comparing clinical and peri-operative outcomes of SILC and conventional laparoscopic cholecystectomy (CLC).

Method

A literature search, including only randomised controlled trials (RCTs), was performed via PubMed, Google Scholar, Cochrane Library and Embase database. The reviewers extracted data from the manuscripts of selected articles including patient demographics, operative time, morbidity rate, post-operative length of stay, conversion rate, cost data, pain and satisfaction with cosmetic results.

Result

Seventeen RCTs matching the inclusion criteria were finally selected for the analysis. A total of 1293 patients were involved in the review, including 663 (51.3 %) patients who have undergone SILC and 630 (48.7 %) patients who have undergone CLC. Post-operative pain was significantly worse in SILC patients in four studies, in CLC patients in four studies, while in the remnants seven studies, no differences in pain scores were found. Data on satisfaction for post-operative cosmetics were significantly better for SILC patients in all studies but two. Operating time was significantly longer in SILC group while there is no statistically significant difference in conversion rate. Morbidity rate was similar in both groups, as was the incidence of bile duct injuries. Costs were significantly higher in SILC group. SILC was considered a more challenging procedure in all studies.

Conclusion

The role of SILC is still controversial. Until now, no real significant benefit has been proven: overall satisfaction is the only clear advantage of SILC, and this is mainly related to cosmetic results. Indications to SILC are mainly limited to patients with uncomplicated disease, with BMI ≤ 30 kg/m2, whose surgery is unlikely to be converted to an open or multiport approach.

Keywords

Single-incision laparoscopic cholecystectomy Single-port-access cholecystectomy Laparoscopic cholecystectomy Gallstones Gallstones treatment Indications to single-port-access cholecystectomy 

Notes

Compliance with ethical standards

Disclosures

Drs. Marco Maria Lirici, Simone Maria Tierno and Cecilia Ponzano have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Marco Maria Lirici
    • 1
  • Simone Maria Tierno
    • 1
  • Cecilia Ponzano
    • 2
  1. 1.Department of SurgerySan Giovanni-Addolorata HospitalRomeItaly
  2. 2.Department of SurgeryRummo HospitalBeneventoItaly

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