Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
권호 표지
DOI QR코드

DOI QR Code

Outcome of single-incision laparoscopic cholecystectomy compared to three-incision laparoscopic cholecystectomy for acute cholecystitis

  • Sanggyun Suh (Department of Surgery, Chung-Ang University Gwangmyeong Hospital) ;
  • Soyeon Choi (Department of Pathology, Ulsan University Hospital) ;
  • YoungRok Choi (Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Boram Lee (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Jai Young Cho (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Yoo-Seok Yoon (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Ho-Seong Han (Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine)
  • Received : 2023.04.27
  • Accepted : 2023.06.18
  • Published : 2023.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Backgrounds/Aims: While single-incision laparoscopic cholecystectomy (SILC) has advantages in cosmesis and postoperative pain, its utilization has been limited. This study raises the possibility of expanding its indication to acute cholecystitis with the novel method of solo surgery under retrospective analysis. Methods: We compared the outcomes of SILC (n = 58) to those of three-incision laparoscopic cholecystectomy (TILC; n = 117) for acute cholecystitis, being performed from March 2014 to December 2015. Results: Intraoperative results, including the operation time, did not differ significantly, except for drain catheter insertion (p = 0.004). Each group had 1 case of open conversion due to common bile duct injury. There was no significant difference in the length of hospital stay. Either group by itself was not a risk factor for complications, but in preoperative drainage for intraoperative perforation, 3 factors of intraoperative perforation, biliary complication, and history of upper abdominal operation for additional port, only American Society of Anesthesiology (ASA) scores for postoperative complication of Clavien-Dindo grades III and IV were significant risk factors. Conclusions: Our study findings showed comparative outcomes between both groups, providing evidence for the safety and feasibility of SILC for acute cholecystitis.

Keywords

References

  1. Milas M, Devedija S, Trkulja V. Single incision versus standard multiport laparoscopic cholecystectomy: up-dated systematic review and meta-analysis of randomized trials. Surgeon 2014;12:271-289.
  2. Sato N, Kohi S, Tamura T, Minagawa N, Shibao K, Higure A. Single-incision laparoscopic cholecystectomy for acute cholecystitis: a retrospective cohort study of 52 consecutive patients. Int J Surg 2015;17:48-53.
  3. Qiu J, Yuan H, Chen S, He Z, Han P, Wu H. Single-port versus conventional multiport laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials and nonrandomized studies. J Laparoendosc Adv Surg Tech A 2013;23:815-831.
  4. Zehetner J, Pelipad D, Darehzereshki A, Mason RJ, Lipham JC, Katkhouda N. Single-access laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials. Surg Laparosc Endosc Percutan Tech 2013;23:235-243.
  5. Cawich SO, Mohanty SK, Felix O, Dapri G. Single incision cholecystectomies for acute cholecystitis: a single surgeon series from the Caribbean. Minim Invasive Surg 2022;2022:6781544.
  6. Sato N, Shibao K, Mori Y, Higure A, Yamaguchi K. Postoperative complications following single-incision laparoscopic cholecystectomy: a retrospective analysis in 360 consecutive patients. Surg Endosc 2015;29:708-713.
  7. Allemann P, Demartines N, Schafer M. Remains of the day: biliary complications related to single-port laparoscopic cholecystectomy. World J Gastroenterol 2014;20:843-851.
  8. Yokoe M, Hata J, Tkada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2018;25:41-54.
  9. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-196.
  10. Lee B, Suh SW, Choi Y, Han HS, Yoon YS, Cho JY, et al. Solo single incision laparoscopic cholecystectomy using the parallel method; surgical technique reducing a steep learning curve. Ann Hepatobiliary Pancreat Surg 2019;23:344-352.
  11. Kim SJ, Lee SC. Technical and instrumental prerequisites for single-port laparoscopic solo surgery: state of art. World J Gastroenterol 2015;21:4440-4446.
  12. Kalteis M, Pistrich R, Schimetta W, Polz W. Laparoscopic cholecystectomy as solo surgery with the aid of a robotic camera holder: a case-control study. Surg Laparosc Endosc Percutan Tech 2007;17:277-282.
  13. Soltes M, Radonak J. A risk score to predict the difficulty of elective laparoscopic cholecystectomy. Wideochir Inne Tech Maloinwazyjne 2014;9:608-612.
  14. Ikumoto T, Yamagishi H, Iwatate M, Sano Y, Kotaka M, Imai Y. Feasibility of single-incision laparoscopic cholecystectomy for acute cholecystitis. World J Gastrointest Endosc 2015;7:1327-1333.
  15. Sasaki K, Watanabe G, Matsuda M, Hashimoto M. Original single- incision laparoscopic cholecystectomy for acute inflammation of the gallbladder. World J Gastroenterol 2012;18:944-951.
  16. Chuang SH, Chen PH, Chang CM, Lin CS. Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis. World J Gastroenterol 2013;19:7743-7750.
  17. Joseph M, Phillips MR, Farrell TM, Rupp CC. Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution. Ann Surg 2012;256:1-6.
  18. Sato N, Yabuki K, Kudo Y, Koga A, Kohi S, Tamura T, et al. Preoperative factors predicting the need for additional ports during single-incision laparoscopic cholecystectomy. Asian J Endosc Surg 2016;9:192-197.
  19. Kim SG, Moon JI, Choi IS, Lee SE, Sung NS, Chun KW, et al. Risk factors for conversion to conventional laparoscopic cholecystectomy in single incision laparoscopic cholecystectomy. Ann Surg Treat Res 2016;90:303-308.
  20. Lee JH, Kim G. The first additional port during single-incision laparoscopic cholecystectomy. JSLS 2020;24:e2020.00024.
  21. Funamizu N, Harada E, Ishiyama S. Comparison of outcomes of single- incision and conventional laparoscopic cholecystectomy for cholecystitis requiring percutaneous transhepatic gallbladder drainage. Asian J Endosc Surg 2020;13:477-480.