Single-port versus needlescopic versus conventional laparoscopic cholecystectomy: a comparative study

Single-port laparoscopic cholecystectomy (LC) has been recently introduced to achieve clinical benefits over standard LC. However, surgical outcomes of this operation have been poorly described compared with current techniques. The purpose of this study is to evaluate the surgical outcomes of single-port LC compared with needlescopic and conventional LC.

We reviewed the surgical outcomes of consecutive patients with symptomatic gallbladder stone disease who underwent single-port LC (31 cases), needlescopic LC (26 cases) and conventional LC (32 cases) from March 2009 to January 2010. Operation time, hospital stay, conversion, complications, and postoperative pain using visual analog scale were analyzed. In addition, patients were interviewed for overall satisfaction and cosmetic results.

BMI in the single-port group was significantly lower than in the conventional group (26.0 ± 4.0 vs 30.8 ± 7.3 kg/m(2) , P=0.0017). Operation time in the single-port group was significantly longer than in the conventional group (65.1 ± 20.1 minutes vs 52.2 ± 19.6 minutes, P=0.012). There was one conversion in the single-port group. In nine cases in the single-port group (29%), a Kirschner wire or a suture retractor helped visualization. There was one complication in the single-port group (wound infection) and one in the needlescopic group (bile leak, requiring laparoscopy). Hospital stay, visual analog scale scores, and overall satisfaction did not vary among these groups. Greater cosmetic satisfaction was shown in the single-port group compared with the conventional group (P=0.039).

Single-port LC is feasible and secure, with better cosmetic results than conventional LC. Further prospective randomized studies are still required to show its superiority over current LC techniques.