title: Single-incision versus conventional laparoscopic cholecystectomy in patients with uncomplicated gallbladder disease: a meta-analysis.
abstract: BACKGROUND
  Laparoscopic cholecystectomy is the gold standard treatment for cholecystectomy. Recently, single-incision laparoscopic cholecystectomy (SILC) has been suggested as an alternative technique.
  
  
  METHODS
  Six databases were searched and reference lists of retrieved articles were checked to identify eligible studies. Data from randomized clinical trials related to the safety and effectiveness of SILC versus conventional laparoscopic cholecystectomy (CLC) were extracted by 2 independent reviewers. Odds ratio and mean differences were calculated with 95% confidence intervals based on intention-to-treat analyses whenever possible.
  
  
  RESULTS
  Fifteen studies with 1113 patients met the eligibility criteria. Methodologic quality was unclear in most trails. Operating time was significantly longer in the single-incision laparoscopic surgery group compared with the CLC group (P<0.00001). Cosmesis was improved in single-incision laparoscopic patients at 1 month (P<0.00001). The pooled mean difference in pain scores at 24 hours was -0.75 in favor of the SILC technique (P=0.04). There was no significant difference in the conversion rates, adverse events, analgesia requirements, or the length of hospital stay between the 2 groups.
  
  
  CONCLUSIONS
  The current evidence shows that patients with uncomplicated cholelithiasis or polypoid lesions of the gallbladder who prefer a better cosmetic outcome, SILC offers a safe alternative to CLC. Further high-powered randomized trials are need to determine whether SILC truly offer any advantages, especially be focused on failure of technique, adverse events, cosmesis, and quality of life.
authors.affiliation: Department of Hepatobiliary Surgery, Chinese PLA the 455st Hospital, Shanghai, People's Republic of China. haolixiao1@163.com
authors.forename: Lixiao
authors.initials: L
authors.lastname: Hao
authors.forename: Moyan
authors.initials: M
authors.lastname: Liu
authors.forename: Hanyu
authors.initials: H
authors.lastname: Zhu
authors.forename: Zuoxiang
authors.initials: Z
authors.lastname: Li
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D017594:Publication Bias; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000700:Analgesics