Preoperative factors predicting the need for additional ports during single-incision laparoscopic cholecystectomy.
BACKGROUND
Single-incision laparoscopic cholecystectomy (SILC) is gaining popularity as a minimally invasive technique that provides some benefits in terms of improved cosmesis. However, the insertion of an additional port is required in a subset of cases.


METHODS
We retrospectively analyzed 308 SILC procedures in patients with benign gallbladder diseases, except acute cholecystitis, to identify preoperative factors predicting the need for an additional port.


RESULTS
SILC was completed with a single incision in 272 patients (88%); the insertion of at least one additional port was required in 36 patients (12%). The additional port requirement was associated with a longer operative time (P < 0.0001), greater intraoperative blood loss (P < 0.0001), and longer postoperative hospital stay (P = 0.0002). Multivariate analysis revealed male gender (odds ratio: 2.57, P = 0.0170), prior history of upper abdominal surgery (odds ratio: 5.53, P = 0.0132), and a higher preoperative white blood cell count (odds ratio: 3.62, P = 0.0244) to be independent factors associated with the requirement for an additional port.


CONCLUSIONS
Our results suggest that gender, prior history of upper abdominal surgery, and white blood cell count can predict the likelihood of requiring an additional port in SILC.
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Norihiro
N
Sato
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Kei
K
Yabuki
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Yuzan
Y
Kudo
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Atsuhiro
A
Koga
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Shiro
S
Kohi
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Toshihisa
T
Tamura
Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Kazunori
K
Shibao
Keiji
K
Hirata
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
additional port; factor; single-incision laparoscopic cholecystectomy