title: Intraumbilical versus periumbilical incision in laparoscopic cholecystectomy: A randomized controlled trial.
abstract: BACKGROUND
  An important issue in laparoscopic surgery is initial peritoneal access. An intraumbilical (IU) incision may be easier and faster to place, but due to concerns about wound complications, the periumbilical (PU) incision is still often used. A prospective randomized controlled study was performed to investigate the outcomes of the IU incision and PU incision in laparoscopic cholecystectomy.
  
  
  METHODS
  Study subjects were patients who received laparoscopic cholecystectomy for acute or chronic cholecystitis, gallbladder polyp or adenomyomatosis, or porcelain gallbladder from June 2014 to January 2015. Enrolled subjects were randomly allocated to the IU incision group or the PU incision group. Demographic data, perioperative outcomes, and the results of a cosmetic satisfaction questionnaire were analyzed.
  
  
  RESULTS
  A total of 130 subjects were analyzed (64 in the IU group, 66 in the PU group). There were no differences in patient demographics. The operation time was significantly shorter in the IU group (34.2 ± 14.6 vs 41.7 ± 21.3, P = 0.020). The cosmetic survey score was significantly higher in the IU group (36.8 ± 5.2 vs 33.2 ± 5.2, P < 0.001). There was no difference in the complication rates of the two groups.
  
  
  CONCLUSIONS
  The IU incision is a safe, feasible method of initial intraperitoneal access that can reduce the operation time and offer superior cosmetic effects to the patient.
authors: Department of Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, South Korea.
authors: Jun Suh
authors: JS
authors: Lee
authors: Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Electronic address: gshth@catholic.ac.kr.
authors: Tae Ho
authors: TH
authors: Hong
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome; D014472:Umbilicus
keywords: Cholecystectomy; Laparoscopic; Laparoscopy; Umbilicus