Single-port laparoscopic cholecystectomy: A comparative study in 106 initial cases

Introduction: Laparoscopic cholecystectomy has been the standard of care for gallbladder diseases since the late 1980s. Many surgeons have rapidly adopted single-port laparoscopic cholecystectomy for gallbladder pathologies. The aim of the present study was to analyze the clinical outcome in initial single-port laparoscopic cholecystectomy. Methods: Data from 106 consecutive single-port laparoscopic cholecystectomies between May 2008 and April 2009 were analyzed retrospectively. We divided the patients into two groups - an early group (group I, n = 56) and a late group (group II, n = 50) - to compare clinical outcomes. During each procedure, only one longitudinal transumbilical incision, 1.5 to 2.0 cm in length, was made to access the abdominal cavity. A multichannel port system was assembled with existing devices. Standard laparoscopic instruments were used to perform each cholecystectomy. Results: Patient demographics did not differ between the two groups. Of the eight cases that were converted to conventional laparoscopic surgery, seven were part of group I (P = 0.063). Mean operation time for single-port laparoscopic cholecystectomy was significantly shorter in group II (58.2 versus 71.6 min, P = 0.004). There were two operative complications in group I, which were successfully managed with laparoscopic surgery. There was no statistical difference in occurrence of operative complication and hospital stay between the two groups. Conclusion: Single-port laparoscopic cholecystectomy can be safely performed for various gallbladder lesions in selected cases, and the operation time improved with accumulation of cases.