title: No difference in incidence of port-site hernia and chronic pain after single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy: a nationwide prospective, matched cohort study.
abstract: BACKGROUND
  Conventional laparoscopic cholecystectomy (CLC) is regarded as the gold standard for cholecystectomy. However, single-incision laparoscopic cholecystectomy (SLC) has been suggested to replace CLC. This study aimed at comparing long-term incidences of port-site hernia and chronic pain after SLC versus CLC.
  
  
  METHODS
  We conducted a matched cohort study based on prospective data (Jan 1, 2009-June 1, 2011) from the Danish Cholecystectomy Database with perioperative information and clinical follow-up. Consecutive patients undergoing elective SLC during the study period were included and matched 1:2 with patients subjected to CLC using pre-defined criteria. Follow-up data were obtained from the Danish National Patient Registry, mailed patient questionnaires, and clinical examination. A port-site hernia was defined as a repair for a port-site hernia or clinical hernia located at one or more port sites.
  
  
  RESULTS
  In total, 699 patients were eligible and 147 patients were excluded from the analysis due to pre-defined criteria. The rate of returned questionnaires was 83%. Thus, 552 (SLC, n = 185; CLC, n = 367) patients were analyzed. The median observation time was 48 months (range 1-65) after SLC and 48 months (1-64) after CLC (P = 0.940). The total cumulated port-site hernia rate was 4 % and 6 % for SLC and CLC, respectively (P = 0.560). Incidences of moderate/severe chronic pain were 4 % and 5 % after SLC and CLC, respectively (P = 0.661).
  
  
  CONCLUSIONS
  We found no difference in long-term incidence of port-site hernia or chronic pain after SLC versus CLC.
authors.affiliation: Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, 2650, Hvidovre, Denmark. mette.willaume@gmail.com.
authors.forename: Mette W
authors.initials: MW
authors.lastname: Christoffersen
authors.affiliation: Surgical Section, Køge Hospital, University of Copenhagen, Køge, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Brandt
authors.affiliation: Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, 2650, Hvidovre, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Oehlenschläger
authors.affiliation: Gastro Unit, Surgical Division, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
authors.affiliation: Surgical Section, Køge Hospital, University of Copenhagen, Køge, Denmark.
authors.forename: Frederik
authors.initials: F
authors.lastname: Helgstrand
authors.affiliation: Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg, Denmark.
authors.forename: Lars N
authors.initials: LN
authors.lastname: Jørgensen
authors.affiliation: Department of Gastrointestinal Surgery and Liver Transplantation, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Linda
authors.initials: L
authors.lastname: Bardram
authors.affiliation: Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Kettegård Allé 30, 2650, Hvidovre, Denmark.
authors.forename: Thue
authors.initials: T
authors.lastname: Bisgaard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D059350:Chronic Pain / Q000453:epidemiology* / Q000209:etiology; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D015994:Incidence; D000069290:Incisional Hernia / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
keywords: Chronic pain; Port-site hernia; Single-site laparoscopic cholecystectomy