Prospective, randomized, controlled clinical study on single-incision laparoscopic cholecystectomy: an analysis of...

Single-incision laparoscopic cholecystectomy (SILC), a minimally invasive alternative to conventional laparoscopic cholecystectomy (CLC), may improve postoperative recovery and cosmetic outcomes but faces concerns about complications and technical demands. This randomized controlled trial compares SILC and CLC using conventional laparoscopic instruments.

891 patients were randomized to SILC (n = 449) or CLC (n = 442). Operative parameters, postoperative recovery, complications, and patient-reported outcomes were evaluated. Primary endpoints were operative time, blood loss, and complication rates. Secondary outcomes included hospital stay, pain scores, and cosmetic satisfaction (Vancouver scar scores).

SILC showed similar operative time (55.11 ± 22.88 vs 51.81 ± 23.61 min, p = 0.907) and blood loss (10.89 ± 26.37 vs 10.14 ± 14.38 ml, p = 0.475) versus CLC. SILC patients had shorter hospitalization (1.94 ± 1.87 vs 2.25 ± 2.49 days, p < 0.001), lower pain scores (2.19 ± 0.88 vs 2.80 ± 0.75, p = 0.016), and better scar outcomes (2.41 ± 1.81 vs 3.54 ± 1.61, p = 0.020). Complication rates like bile leakage and hernias were marginally higher in SILC but not statistically significant.

SILC is a safe, effective alternative to CLC, offering better postoperative recovery and cosmetic results. However, patient selection and surgical expertise are crucial to optimize outcomes and minimize complications.