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Single-Incision Laparoscopic Cholecystectomy Versus Standard Multiport Approach for Gallbladder Disease in Children:
Xiaoyu Deng1,2, Zechuan Jin3, Yongqiong Tan1,2
1Operating Room, West China Hospital, Sichuan University, Chengdu, China.
Insights
Single-incision laparoscopic cholecystectomy (SILC) and standard multiport laparoscopic cholecystectomy (SLC) show similar outcomes in children. Both procedures demonstrate comparable operative times, hospital stays, and complication rates for pediatric patients.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic cholecystectomy is a common procedure for pediatric patients with hematological or biliary disorders.
- Single-incision laparoscopic cholecystectomy (SILC) offers a potentially less invasive alternative to standard multiport laparoscopic cholecystectomy (SLC).
Approach:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Seven studies comprising 479 pediatric patients (235 SILC, 244 SLC) were analyzed.
- Key outcomes including operative time, hospital stay, and postoperative complications were extracted and compared.
Key Points:
- No statistically significant difference was observed between SILC and SLC in operative time (P=.07) or length of hospital stay (P=.62).
- Postoperative complication rates and costs were also found to be similar between the two surgical approaches.
- Both SILC and SLC appear to be equally effective and safe for managing cholecystectomy in children.
Conclusions:
- SILC and SLC demonstrate comparable efficacy and safety profiles in pediatric patients undergoing cholecystectomy.
- Further high-quality randomized controlled trials with larger sample sizes and long-term follow-up are warranted to solidify these findings.
Abstract:
To evaluate comparative outcomes of single-incision laparoscopic cholecystectomy (SILC) and standard multiport laparoscopic cholecystectomy (SLC) in the management of children with various hematological or biliary disorders. A comprehensive systematic review of literature studies with subsequent meta-analysis of outcomes was conducted in line with preferred reporting items for systematic reviews and meta-analyses statement standards. Operative time, length of hospital stay, and postoperation complications were extracted. Seven researches reporting a total number of 479 patients who underwent SILC (n = 235) or SLC (n = 244) were included. There was no difference between SILC and SLC groups in operative time (mean difference (MD) 15.14, 95% confidence interval [CI] [10.50-19.79], P = .07) and length of hospital stay (MD 0.83, 95% CI [-2.41 to 4.06], P = .62). Postoperation complications and the cost also seemed similar. SILC and SLC seem to have comparable effect and safety in children. Future high-quality randomized controlled trials with adequate sample sizes and long-term follow-up are required to provide stronger evidence in favor of the intervention.
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