Single-incision versus conventional multiport laparoscopic cholecystectomy: a current meta-analysis of randomized controlled trials

Abstract

Background

We performed this study to compare the safety and feasibility of single-incision laparoscopic cholecystectomy (SILC) with conventional multiple-port laparoscopic cholecystectomy (MPLC).

Methods

We searched PubMed, Embase, Web of Science, the Cochrane Controlled Register of Trials (CENTRAL), and ClinicalTrials.gov for randomized controlled trials comparing SILC versus MPLC. We evaluated the pooled outcomes for complications, pain scores, and surgery-related events. This study was performed in accordance with PRISMA guidelines.

Results

A total of 48 randomized controlled trials involving 2838 patients in the SILC group and 2956 patients in the MPLC group were included in this study. Our results showed that SILC was associated with a higher incidence of incisional hernia (relative risk = 2.51; 95% confidence interval = 1.23–5.12; p = 0.01) and longer operation time (mean difference = 15.27 min; 95% confidence interval = 9.67–20.87; p < 0.00001). There were no significant differences between SILC and MPLC regarding bile duct injury, bile leakage, wound infection, conversion to open surgery, retained common bile duct stones, total complication rate, and estimated blood loss. No difference was observed in postoperative pain assessed by a visual analogue scale between the two groups at four time points (6 h, 8 h, 12 h, and 24 h postprocedure).

Conclusions

Based on the current evidence, SILC did not result in better outcomes compared with MPLC and both were equivalent regarding complications. Considering the additional surgical technology and longer operation time, SILC should be chosen with careful consideration.

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Data availability

All the data used in the study can be obtained from the original articles.

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Acknowledgements

We thank Jane Charbonneau, DVM from Liwen Bianji, Edanz Group China (www.liwenbianji.cn/ac) for editing the English text of a draft of this manuscript.

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Correspondence to Yunxiao Lyu.

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Yunxiao Lyu, Yunxiao Cheng, Bin Wang, Sicong Zhao, and Liang Chen have no conflicts of interest or financial ties to disclose.

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Lyu, Y., Cheng, Y., Wang, B. et al. Single-incision versus conventional multiport laparoscopic cholecystectomy: a current meta-analysis of randomized controlled trials. Surg Endosc 34, 4315–4329 (2020). https://doi.org/10.1007/s00464-019-07198-8

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Keywords

  • Laparoscopic cholecystectomy
  • Single-incision
  • Conventional
  • Meta-analysis
  • Systematic review