title: The real-world application of single incision laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Most previous studies that have investigated single incision laparoscopic cholecystectomy (SILC) are case series with limited sample sizes. We have reviewed the outcome of 500 consecutive cases of SILC performed by a single surgeon at our center.
  
  
  METHODS
  From April 2009 to October 2012, a single surgeon performed 1250 laparoscopic cholecystectomies for various gallbladder (GB) diseases. SILC was chosen as the surgical modality unless there was evidence of acute cholecystitis or GB empyema, the patient had a prior history of upper abdominal surgery, endoscopic sphincterotomy, or had comorbidities with an ASA score of III or higher. The clinicopathologic features and perioperative data of patients were retrospectively reviewed.
  
  
  RESULTS
  The mean age and BMI of included patients were 42.7 years and 23.6 kg/m(2), respectively. The mean operating time was 52 min. Patients stayed in the hospital for an average of 1.3 days postoperatively. In 55 patients, an additional 2 mm trocar was inserted for retraction of the GB. One patient was converted to an open cholecystectomy because of Mirizzi syndrome. There were no observed complications including incisional hernias in this patient population.
  
  
  CONCLUSIONS
  SILC is a safe, effective procedure for cholecystectomy that may be considered the main surgical strategy in select patients.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hyo Jun
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jaehong
authors.initials: J
authors.lastname: Jeong
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Hui Song
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Juhee
authors.initials: J
authors.lastname: Cho
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: jinseok.heo@samsung.com.
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Heo
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Choi
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Choi
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000601:surgery; D041881:Cholecystitis, Acute / Q000601:surgery; D000075202:Contraindications; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D057792:Mirizzi Syndrome / Q000150:complications; D061646:Operative Time; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome
keywords: Cholecystectomy; Cholecystitis; Laparoscopic surgery; Minimal invasive surgery