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Single-port laparoscopic cholecystectomy versus the classical four port laparoscopic cholecystectomy: a randomized
K Emre Telciler1, E Ilhan, S Yakan
1Izmir Bozyaka Educational and Research Hospital General Surgery, Izmir, Turkey - drfevzi@gmail.com.
Aim:
The objectives of this prospective study were to compare the advantages of single-port laparoscopic cholecystectomy (SPLC) versus the classical four-port laparoscopic cholecystectomy (CLC) and to discuss these advantages in the light of current literature.
Methods:
Forty eligible patients were randomized to receive SPLC (Group A, N.=20) and CLC (Group B, N.=20), and investigated with regard to age, sex, BMI (body mass index), ASA (American Society of Anesthesiologists) score, type of surgery, operative time, per-operative complication, indication for conversion to open surgery, indication for additional trocar placement in SPLC technique, post-operative pain score, additional narcotic analgesic requirement, nausea and vomiting, post-operative complication and length of hospital stay. Visual analogue scale (VAS) was used for pain scoring in all cases.
Results:
No significant difference was found among patients in Group A and Group B in terms of age, sex, weight/BMI, ASA score, VAS scores, additional analgesic requirement and length of hospital stay (P>0.05). On the other hand, mean operative time in Group A was significantly (P<0.005) greater than that in Group B. Mean operative time in Group A was observed to be reduced after the first 10 operations. Conversion to open surgery was not required in any of the patients; however, additional trocar placement was required in two patients in Group A due to body habitus and adhesions, and operations were completed laparoscopically.
Conclusion:
We conclude that SPLC is equally effective as CLC. Patient comfort is increased and pain is decreased as the surgeon gets experienced with the technique.
