Comparison of postoperative pain between single-incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy: prospective case-control study.
BACKGROUND
Single-incision laparoscopic cholecystectomy (SILC) is an emerging technique used in cholecystectomy. Nevertheless, studies on the difference in postoperative pain between SILC and conventional laparoscopic cholecystectomy are lacking in the literature.


METHODS
From August 2009 to July 2010, 20 consecutive patients who underwent SILC (SILC group) were compared with a prospective cohort of 20 patients who underwent conventional 4-port laparoscopic cholecystectomy (LC group) during the same period. Standard postoperative analgesic protocol was applied to all patients. Pain scores were registered before operation and one day after operation using visual analog scale. Satisfactory score was self-assessed by all patients one month after surgery using visual analog scale.


RESULTS
There was no significant difference in the baseline characteristics, preoperative pain score, and intraoperative opioid usage between the 2 groups. The postoperative pain score was significantly lower in the SILC group (2.9±1.6 in SILC group vs. 4.8±1.5 in LC group, P<0.01). There was also a lower analgesic consumption and a higher satisfactory score in the SILC group although the results did not reach statistical significance.


CONCLUSIONS
SILC resulted in significantly less postoperative pain than conventional laparoscopic cholecystectomy. It is a safe alternative to conventional laparoscopic cholecystectomy.
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. jeffwong@surgery.cuhk.edu.hk
Jeff Siu-Wang
JS
Wong
Yue-Sun
YS
Cheung
Kwong-Wai
KW
Fong
Charing Ching-Ning
CC
Chong
Kit-Fai
KF
Lee
John
J
Wong
Paul Bo-San
PB
Lai
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D042882:Gallstones / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D017060:Patient Satisfaction; D010865:Pilot Projects; D011127:Polyps / Q000601:surgery; D011446:Prospective Studies; D014147:Tramadol / Q000627:therapeutic use; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D014147:Tramadol