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Meta-analysis of Prospective Randomized Studies Comparing Single-Incision Laparoscopic Cholecystectomy (SILC) and Conventional Multiport Laparoscopic Cholecystectomy (CMLC)

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Single-incision laparoscopic cholecystectomy (SILC) has gained acceptance among surgeons as there is a trend to minimize the invasiveness of laparoscopy. The aim of this meta-analysis has been to assess the feasibility and safety of SILC when compared to conventional multiport laparoscopic cholecystectomy (CMLC).

Methods

A literature search for trials comparing SILC and CMLC was performed. Studies were reviewed for the outcomes of interest: patient characteristics; operative time and conversion rate; postoperative pain; length of hospital stay; postoperative complications; and patient satisfactory score (0–10). Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for qualitative variables.

Results

Twelve prospective randomized trials comparing SILC and CMLC were analyzed. Overall, 892 patients were randomized to either SILC (465) or CMLC (427). Operative time was significantly longer in SILC (63.0 vs. 45.8 min, SMD = 1.004, 95% CI = 0.434–1.573). Patient satisfactory score significantly favored SILC (8.2 vs. 7.2, SMD = −0.759, 95% CI = −1.064 to −0.455). No other difference was found.

Conclusions

SILC is a safe and effective procedure for the treatment of uncomplicated benign gallbladder disease with a significant patient satisfaction. New multicenter randomized trials are expected to evaluate SILC in more complex circumstances such as acute cholecystitis, previous abdominal surgery, and severe obesity.

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Acknowledgments

This study was supported by a grant from the University of Cagliari, Italy (quota ex 60 %). We would like to thank Dr. Eric C.H. Lai from the Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China, for the help in calculating patient satisfactory scores.

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Authors and Affiliations

  1. Clinica Chirurgica, University of Cagliari, Azienda Ospedaliero-Universitaria, Presidio Policlinico di Monserrato, Blocco G, SS 554 km 4,500, 09042, Monserrato, Cagliari, Italy

    Adolfo Pisanu, Isabella Reccia, Giulia Porceddu & Alessandro Uccheddu

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  1. Adolfo Pisanu
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  2. Isabella Reccia
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  3. Giulia Porceddu
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  4. Alessandro Uccheddu
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Correspondence to Adolfo Pisanu.

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Pisanu, A., Reccia, I., Porceddu, G. et al. Meta-analysis of Prospective Randomized Studies Comparing Single-Incision Laparoscopic Cholecystectomy (SILC) and Conventional Multiport Laparoscopic Cholecystectomy (CMLC). J Gastrointest Surg 16, 1790–1801 (2012). https://doi.org/10.1007/s11605-012-1956-9

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  • DOI: https://doi.org/10.1007/s11605-012-1956-9

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