Single-Incision Laparoscopic Surgery Versus Standard Laparoscopic Surgery for Unroofing of Hepatic Cysts

Background and Objectives: The aim of this report is to document the feasibility and safety of umbilical single-incision laparoscopic liver cyst unroofing in the treatment of simple hepatic cysts in a retrospective case-control study. We also introduce some operative skills for single-incision laparoscopic surgery. Methods: From May 2009 to July 2011, 15 patients underwent umbilical single-incision laparoscopic liver cyst unroofing. All the clinical data were retrospectively analyzed. Another 15 simple liver cyst patients who received standard laparoscopic liver cyst unroofing at our hospital during the same period-with a similar age, nature of the cyst, and position to the single-incision group-were selected to undergo a case-control study. The operative time, blood loss, recovery time of gastrointestinal function, volume of postoperative drainage, postoperative drainage time, postoperative hospitalization time, and postoperative recurrence rate were compared between the two groups. Results: There was no significant difference between the single-incision group and standard group in operative time (58.3 +/- 7.43 minutes vs 58.7 +/- 6.14 minutes), blood loss (17.0 +/- 3.19 mL vs 14.7 +/- 1.86 mL), recovery time of gastrointestinal function (2.5 +/- 0.22 days vs 2.4 +/- 0.22 days), volume of postoperative drainage (408.0 +/- 119.5 mL vs 450.0 +/- 89.5 mL), postoperative drainage time (2.6 +/- 0.55 days vs 3.7 +/- 0.59 days), or postoperative hospitalization time (4.8 +/- 0.44 days vs 5.2 +/- 0.56 days) (P > .05). The postoperative follow-up period was 1 to 24 months. Conclusions: Compared with standard laparoscopic liver cyst unroofing, single-incision laparoscopic liver cyst unroofing shows no significant difference during the overall treatment process. In addition to the advantages of less trauma, more rapid recovery, and shorter hospital stay, single-incision laparoscopic surgery can reach the effect of "no scar" and can be safely and effectively carried out.