title: Risk factors for a prolonged operative time in a single-incision laparoscopic cholecystectomy.
abstract: BACKGROUND
  A prolonged operative time is associated with adverse post-operative outcomes in laparoscopic surgery. Although a single-incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown.
  
  
  METHODS
  A total of 20 clinical variables were retrospectively reviewed to identify factors for a prolonged operative time (longer than 3 h) in a total of 220 consecutive patients undergoing SILC.
  
  
  RESULTS
  The median operative time was 145 min (range, 55-435) and a prolonged operative time was required in 62 patients (28%). Independent factors that predict a prolonged operative time as identified through multivariate analysis were body mass index (BMI) (P = 0.009), acute cholecystitis (P < 0.001) and operator (resident or staff surgeon) (P < 0.001). Furthermore, a prolonged operative time was significantly associated with an increased amount of intra-operative blood loss (P < 0.001) and a prolonged stay after surgery (P < 0.001).
  
  
  CONCLUSIONS
  These findings suggest that a higher BMI, acute cholecystitis and a resident as an operator significantly increase the duration of SILC procedures.
authors.affiliation: Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sato
authors.forename: Kei
authors.initials: K
authors.lastname: Yabuki
authors.forename: Kazunori
authors.initials: K
authors.lastname: Shibao
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Mori
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Tamura
authors.forename: Aiichiro
authors.initials: A
authors.lastname: Higure
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D041881:Cholecystitis, Acute / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
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