title: Single-incision laparoscopic cholecystectomy: from four wounds to one.
abstract: OBJECTIVE
  To review the initial results and surgical outcomes of single-incision laparoscopic cholecystectomy.
  
  
  METHODS
  Prospective case series.
  
  
  METHODS
  A university teaching hospital and a regional hospital in Hong Kong.
  
  
  METHODS
  All patients undergoing single-incision laparoscopic cholecystectomy from August 2009 to March 2011.
  
  
  RESULTS
  Fifty patients underwent single-incision laparoscopic cholecystectomy during the study period. The indications for surgery included symptomatic gallstones (n=43) and gallbladder polyps (n=7). The mean operating time was 78 (standard deviation, 24) minutes. Forty-five of the patients successfully underwent single-incision laparoscopic cholecystectomy, giving a success rate of 90%. In the remaining five patients, additional working ports were constructed to obtain better exposure and dissection around Calot's triangle. On comparing the results of the initial 25 cases to the subsequent 25 cases, in the latter group the operating time was significantly shorter (86 vs 71 minutes; P=0.02), and the success rate was higher (80% vs 100%; P=0.05). During the median follow-up period of 6.8 months, four patients had complications, which included: postoperative urinary retention (n=2), one each with a haematoma and an incisional hernia. No patient endured bile duct injury, postoperative bile leakage, or haemorrhage in our series.
  
  
  CONCLUSIONS
  Single-incision laparoscopic cholecystectomy is feasible and safe for treatment of uncomplicated gallbladder diseases. There was a reduction in the operating time and increase in success rate with accumulation of experience. Nevertheless, surgeons should be cautious about the potential risks of this new technique.
authors.affiliation: Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: Jeff S W
authors.initials: JS
authors.lastname: Wong
authors.forename: Y S
authors.initials: YS
authors.lastname: Cheung
authors.forename: K W
authors.initials: KW
authors.lastname: Chan
authors.forename: Charing C N
authors.initials: CC
authors.lastname: Chong
authors.forename: K F
authors.initials: KF
authors.lastname: Lee
authors.forename: John
authors.initials: J
authors.lastname: Wong
authors.forename: Paul B S
authors.initials: PB
authors.lastname: Lai
mesh_terms: D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D005260:Female; D005706:Gallbladder Neoplasms / Q000601:surgery*; D042882:Gallstones / Q000601:surgery; D006406:Hematoma / Q000209:etiology; D046449:Hernia, Abdominal / Q000209:etiology; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000601:surgery; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology