Laparoscopic Cholecystectomy: Single-port vs Traditional Procedure: Our Experience

Background: Laparoscopic surgery is widely accepted as a reliable alternative to the open approach across surgical disciplines. Benefits of single-incision laparoscopic surgery (SILS), as exemplified here by single-port laparoscopic cholecystectomy (SPLC), have yet to be formally proved. However, the hypothesized benefits of SILS would include those of standard traditional laparoscopic surgery plus improved esthetic outcomes, with surgery being performed through a single hidden incision. Methods: All patients who had chronic calcular cholecystitis at the General Surgery Department at Mansoura University Hospital between May 2014 and May 2018 were eligible for this study to compare SPLC with multiport laparoscopic cholecystectomy (MPLC). Operative and perioperative outcomes, including cosmesis, were analyzed. Results: SPLC had been performed in Group A (40 patients), mean age was 37.35 ± 10.72, 80% were females, and mean BMI was 30.15 ± 4.53. MPLC was performed in Group B (40 patients), mean age was 40.70 ± 9.71, 75% were females, and mean BMI was 28.35 ± 2.83. The average duration of postoperative hospital stay in SPLC cases was 24 hours and in MPLC group was 25.20 hours, with p = 0.330, which was insignificant. In the SPLC group, the mean operative time was 95.75 minutes whereas in the MPLC group the mean operative time was 42.10 minutes. Therefore, the mean operative time in the SPLC group was significantly higher than in the MPLC group (p <0.01). Esthetic results were better in the SPLC group than in the MPLC group. Conclusion: Based on the current findings, SPLC seems to be a safe procedure in uncomplicated cholecystitis with rapid recovery, less postoperative pain, less wound infection, and better cosmesis. The operative time was long. However, patients should be aware of the risks of port-site incisional hernia and instructed to avoid heavy work and exercises during the first three postoperative months.