Is routine single-incision laparoscopic cholecystectomy feasible? A retrospective observational study.
BACKGROUND
Single-incision laparoscopic cholecystectomy (SILC) has been shown to be safe for uncomplicated gallbladder diseases. Routinely applying SILC is debatable.


METHODS
Two hundred SILCs were performed with single-incision multiple-port longitudinal-array and self-camera techniques.


RESULTS
Eighty-eight (44%) procedures were scheduled for complicated diseases. The routine group had a higher comorbidity rate, a lower preoperative endoscopic retrograde cholangiopancreatography rate, a higher intraoperative cholangiography rate, a higher proportion of complicated gallbladder diseases, shorter operative time, more intraoperative blood loss, and lower postoperative pethidine dose than the selective group (the first 73 patients). The conversion and complication rates showed no statistical difference. It took fewer cases but longer time to pass the learning phase of SILC for complicated gallbladder diseases. The multivariate analysis showed that male sex and complicated gallbladder diseases were associated with a higher procedure conversion rate, and increased patient age was related to a higher complication rate.


CONCLUSIONS
Routine SILC for benign gallbladder diseases is feasible in the experienced phase. Practicing SILC for uncomplicated gallbladder diseases helps to achieve competence in this technique for complicated diseases.
Department of Surgery, Mackay Memorial Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan; Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan.
Shu-Hung
SH
Chuang
Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan.
Wen-Jui
WJ
Yang
Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Nursing, Mackay Memorial Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan.
Chih-Ming
CM
Chang
Department of Biological Science and Technology, National Chiao Tung University, Hsin-Chu, Taiwan.
Chih-Sheng
CS
Lin
Department of Surgery, Mackay Memorial Hospital, Hsin-Chu Branch, Hsin-Chu, Taiwan. Electronic address: a4381@ms7.mmh.org.tw.
Meng-Ching
MC
Yeh
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
Cholecystitis; Gallbladder disease; Laparoendoscopic single-site cholecystectomy; Learning curve; Routine; Single-incision laparoscopic cholecystectomy