Systematic Review of Utilized Ports in Laparoscopic Cholecystectomy: Pushing the Boundaries

Surgical procedures have undergone a paradigm shift in the last 3 decades, with minimally invasive surgery becoming standard of care for a number of surgeries, including the treatment of benign gallbladder diseases. By providing a thorough and impartial summary of the earlier published systematic reviews, the current systematic review is the first to present comparison results. This review illustrates the data of intraoperative and postoperative results of each laparoscopic cholecystectomy technique.

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was meticulously followed to conduct the present systematic review. MEDLINE (via PubMed), Cochrane Database of Systematic Reviews, and Web of Science were searched for eligible publications, and a total of 14 systematic reviews were included. A newly developed extraction table was utilized to obtain the predefined parameters from eligible systematic reviews, including operative time, conversion rate, estimated blood loss, bile leak, length of hospital stay, postoperative pain, and cosmetic results. All statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) software, version 26.0. The analysis of dichotomous results was summarized using relative risks and 95% confidence intervals (95% CI), and continuous results were summarized using mean differences and 95% CIs. The proportions were compared using a single proportion z-test.

The analysis of our primary and secondary outcomes revealed a statistically significant improvement in aesthetic results after single-incision laparoscopic cholecystectomy (SILC) in comparison to the multiport approach of laparoscopic cholecystectomy. This, however, is accompanied by extended operative timing and subsequently, prolonged exposure to anesthesia.

Patients should be carefully selected for SILC to minimize technical difficulties and prevent complications both intraoperatively and shortly after the procedure. This trial is registered with CRD42023392037.