The chronological change of indications and outcomes for single-incision laparoscopic cholecystectomy: a Korean multicenter study

Abstract

Background

Although single-incision laparoscopic cholecystectomy (SILC) is a common procedure, the change in its surgical indications and perioperative outcomes has not been analyzed.

Methods

We collected the clinical data of patients who underwent pure SILC in 9 centers between 2009 and 2018 and compared the perioperative outcomes.

Results

In this period, 6497 patients underwent SILC. Of these, 2583 were for gallbladder (GB) stone (39.7%), 774 were for GB polyp (11.9%), 994 were for chronic cholecystitis (15.3%), and 1492 were for acute cholecystitis (AC) (23%). 162 patients (2.5%) experienced complication, including 20 patients (0.2%) suffering from biliary leakage. The number of patients who underwent SILC for AC increased over time (p = 0.028), leading to an accumulation of experience (27.4 vs 23.7%, p = 0.002). The patients in late period were more likely to have undergone a previous laparotomy (29.5 vs 20.2%, p = 0.006), and to have a shorter operation time (47.0 vs 58.8 min, p < 0.001). Male (odds ratio [OR]; 1.673, 95% confidence interval [CI] 1.090–2.569, p = 0.019) and moderate or severe acute cholecystitis (OR; 2.602, 95% CI 1.677–4.037, p < 0.001) were independent predictive factors for gallbladder perforation during surgery, and open conversion (OR; 5.793, 95% CI 3.130–10.721, p < 0.001) and pathologically proven acute cholecystitis or empyema (OR; 4.107, 95% CI 2.461–6.854, p < 0.001) were related with intraoperative gallbladder perforation

Conclusion

SILC has expanded indication in late period. In this period, the patients had shorter operation times and a similar rate of severe complications, despite there being more numerous patients with AC.

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Correspondence to In Seok Choi.

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Woohyung Lee, Young Hoon Roh, Sung Hwa Kang, Chung Yun Kim, YoungRok Choi, Ho-Seong Han, Hyung Joon Han, Tae-Jin Song, Chang Moo Kang, Woo Jung Lee, Sung Hoon Choi, Sung Yub Jeong, Tae Ho Hong, Young Kyoung You, Jae Hoon Lee, Ju Ik Moon, and In Seok Choi have nothing to disclose.

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Lee, W., Roh, Y.H., Kang, S.H. et al. The chronological change of indications and outcomes for single-incision laparoscopic cholecystectomy: a Korean multicenter study. Surg Endosc (2020). https://doi.org/10.1007/s00464-020-07748-5

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Keywords

  • Single-incision laparoscopic cholecystectomy
  • Surgical indication
  • Acute cholecystitis
  • Postoperative complication