title: Single-incision laparoscopic cholecystectomy: a comparison with the gold standard.
abstract: BACKGROUND
  Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC.
  
  
  METHODS
  A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis, operative data, pain control in the recovery room, complications, length of hospital stay, and cost were compared between the two groups.
  
  
  RESULTS
  Of the 285 patients, 177 underwent LC and 108 underwent SILC. The mean age was 49.7 years for the LC patients and 48.2 years for the SILC patients (p = 0.44). Two of the LC patients underwent conversion to open surgery. None of SILC patients were converted to open procedure, although nine had additional ports placed. After multivariate adjustment, SILC was associated with a 15% longer operative time (p = 0.053) and a 66% shorter hospital stay (p = 006) than LC. Biliary dyskinesia and biliary colic were independently associated with shorter operative times and a reduced hospital stay. No significant differences were noted in pain score, narcotics used in the postanesthesia care unit (PACU), 30-day complication rates (1.7 vs 1.9%; p = 1), hospital charges, or cost between the two groups.
  
  
  CONCLUSIONS
  Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.
authors.affiliation: Department of Surgery, University of Missouri, Kansas City, USA.
authors.forename: Sigi
authors.initials: S
authors.lastname: Joseph
authors.forename: B Todd
authors.initials: BT
authors.lastname: Moore
authors.forename: G Brent
authors.initials: GB
authors.lastname: Sorensen
authors.forename: John W
authors.initials: JW
authors.lastname: Earley
authors.forename: Fengming
authors.initials: F
authors.lastname: Tang
authors.forename: Phil
authors.initials: P
authors.lastname: Jones
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Brown
mesh_terms: D000328:Adult; D001657:Biliary Dyskinesia / Q000601:surgery; D001660:Biliary Tract Diseases / Q000601:surgery; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000379:methods* / Q000592:standards; D002764:Cholecystitis / Q000601:surgery; D003085:Colic / Q000601:surgery; D015897:Comorbidity; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007615:Kansas; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology; D010195:Pancreatitis / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D009294:Narcotics