title: Single-fulcrum laparoscopic cholecystectomy in uncomplicated gallbladder diseases: a retrospective comparative analysis with conventional laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Single-fulcrum laparoscopic cholecystectomy (SFLC) is a variant type of single incision and multi-port technique that does not use specialized one-port devices or articulating instruments. We retrospectively compared perioperative outcomes of SFLC with those of conventional laparoscopic cholecystectomy (CLC).
  
  
  METHODS
  Between March 2009 and December 2010, SFLC was performed in 130 patients. Among them, 105 patients with uncomplicated gallbladder disease (no inflammation or no clinical symptoms) and another 105 patients who underwent CLC were selected for this study.
  
  
  RESULTS
  There was no open conversion. In comparison with CLC, SFLC was performed more often in young (46.4±12.2 years vs. 52.5±13.6 years, p=0.001) female patients (80/25 vs. 62/43, p=0.008). The total operation time was longer in SFLC (56.7±14.1 min vs. 47.5±17.1 min, p<0.001), but pain scores immediately after operation and at discharge time were lower for SFLC than for CLC (3.1±1.3 vs. 4.0±1.9, p<0.001, 2.0±0.9 vs. 2.4±0.8, p=0.002). Total cost was lower for SFLC than for CLC (US $ 1801±289.9 vs. US $ 2003±617.4, p=0.004). There were no differences in hospital stay or complication rates.
  
  
  CONCLUSIONS
  SFLC showed greater technical feasibility and cost benefits in treating uncomplicated benign gallbladder disease than CLC.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. cmkang@yuhs.ac.
authors.forename: Ho Kyoung
authors.initials: HK
authors.lastname: Hwang
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Chang Moo
authors.initials: CM
authors.lastname: Kang
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005705:Gallbladder Diseases / Q000191:economics / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Laparoscopic; cholecystectomy; single incision; single port