A prospective controlled trial comparing single-incision and conventional laparoscopic cholecystectomy: caution before damage control.
OBJECTIVE
To evaluate the safety and feasibility of single-incision laparoscopic cholecystectomy (SILS-C) compared with conventional laparoscopic cholecystectomy (CLC).


METHODS
Sixty-five patients (SILS-C: 35, CLC: 30) were prospectively enrolled and operated with conventional straight instruments. The postoperative pain scores at 6, 24 hours, and 1 week, nausea, vomiting, commencement of oral intake, hospital stay, resumption of normal activities and work and satisfaction levels were noted.


RESULTS
Twenty-eight percent (10/35) SILS-C patients required introduction of additional trocars to complete the procedure. No patient required conversion to open. All the morbidity parameters were similar in both the groups, except that the seroma formation in the wound was significantly higher in the SILS-C group [SILS-C: 17% (6/35)/CLC: 0%, P=0.038]. One patient in SILS-C had a major bile duct injury.


CONCLUSIONS
SILS-C is safe and feasible with conventional instruments. However, caution needs to be exercised in view of a major bile duct injury and a higher rate of seroma formation in the wound.
SGHS Multi-specialty Hospital, Mohali, Punjab, India. drgargpankaj@yahoo.com
Pankaj
P
Garg
Jai Deep
JD
Thakur
Iqbal
I
Singh
Nikhilesh
N
Nain
Garima
G
Mittal
Vikas
V
Gupta
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D011446:Prospective Studies