Single-incision laparoscopic cholecystectomy: A comparison with the gold standard

Sigi Joseph, B. Todd Moore, G. Brent Sorensen, John W. Earley, Fengming Tang, Phil Jones, Kimberly M. Brown

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC. Methods A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis, operative data, pain control in the recovery room, complications, length of hospital stay, and cost were compared between the two groups. Results Of the 285 patients, 177 underwent LC and 108 underwent SILC. The mean age was 49.7 years for the LC patients and 48.2 years for the SILC patients (p = 0.44). Two of the LC patients underwent conversion to open surgery. None of SILC patients were converted to open procedure, although nine had additional ports placed. After multivariate adjustment, SILC was associated with a 15% longer operative time (p = 0.053) and a 66% shorter hospital stay (p = 006) than LC. Biliary dyskinesia and biliary colic were independently associated with shorter operative times and a reduced hospital stay. No significant differences were noted in pain score, narcotics used in the postanesthesia care unit (PACU), 30-day complication rates (1.7 vs 1.9%; p = 1), hospital charges, or cost between the two groups. Conclusions Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.

Original languageEnglish (US)
Pages (from-to)3008-3015
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume25
Issue number9
DOIs
StatePublished - Sep 2011
Externally publishedYes

Fingerprint

Laparoscopic Cholecystectomy
Length of Stay
Hospital Costs
Operative Time
Biliary Dyskinesia
Conversion to Open Surgery
Hospital Charges
Recovery Room
Social Adjustment
Pain
Colic
Narcotics

Keywords

  • Cholecystectomy
  • Gallbladder
  • Laparoscopy
  • Surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Joseph, S., Moore, B. T., Sorensen, G. B., Earley, J. W., Tang, F., Jones, P., & Brown, K. M. (2011). Single-incision laparoscopic cholecystectomy: A comparison with the gold standard. Surgical Endoscopy and Other Interventional Techniques, 25(9), 3008-3015. https://doi.org/10.1007/s00464-011-1661-x

Single-incision laparoscopic cholecystectomy : A comparison with the gold standard. / Joseph, Sigi; Moore, B. Todd; Sorensen, G. Brent; Earley, John W.; Tang, Fengming; Jones, Phil; Brown, Kimberly M.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 25, No. 9, 09.2011, p. 3008-3015.

Research output: Contribution to journalArticle

Joseph, S, Moore, BT, Sorensen, GB, Earley, JW, Tang, F, Jones, P & Brown, KM 2011, 'Single-incision laparoscopic cholecystectomy: A comparison with the gold standard', Surgical Endoscopy and Other Interventional Techniques, vol. 25, no. 9, pp. 3008-3015. https://doi.org/10.1007/s00464-011-1661-x
Joseph, Sigi ; Moore, B. Todd ; Sorensen, G. Brent ; Earley, John W. ; Tang, Fengming ; Jones, Phil ; Brown, Kimberly M. / Single-incision laparoscopic cholecystectomy : A comparison with the gold standard. In: Surgical Endoscopy and Other Interventional Techniques. 2011 ; Vol. 25, No. 9. pp. 3008-3015.
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abstract = "Background Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC. Methods A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis, operative data, pain control in the recovery room, complications, length of hospital stay, and cost were compared between the two groups. Results Of the 285 patients, 177 underwent LC and 108 underwent SILC. The mean age was 49.7 years for the LC patients and 48.2 years for the SILC patients (p = 0.44). Two of the LC patients underwent conversion to open surgery. None of SILC patients were converted to open procedure, although nine had additional ports placed. After multivariate adjustment, SILC was associated with a 15{\%} longer operative time (p = 0.053) and a 66{\%} shorter hospital stay (p = 006) than LC. Biliary dyskinesia and biliary colic were independently associated with shorter operative times and a reduced hospital stay. No significant differences were noted in pain score, narcotics used in the postanesthesia care unit (PACU), 30-day complication rates (1.7 vs 1.9{\%}; p = 1), hospital charges, or cost between the two groups. Conclusions Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.",
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AU - Tang, Fengming

AU - Jones, Phil

AU - Brown, Kimberly M.

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N2 - Background Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC. Methods A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis, operative data, pain control in the recovery room, complications, length of hospital stay, and cost were compared between the two groups. Results Of the 285 patients, 177 underwent LC and 108 underwent SILC. The mean age was 49.7 years for the LC patients and 48.2 years for the SILC patients (p = 0.44). Two of the LC patients underwent conversion to open surgery. None of SILC patients were converted to open procedure, although nine had additional ports placed. After multivariate adjustment, SILC was associated with a 15% longer operative time (p = 0.053) and a 66% shorter hospital stay (p = 006) than LC. Biliary dyskinesia and biliary colic were independently associated with shorter operative times and a reduced hospital stay. No significant differences were noted in pain score, narcotics used in the postanesthesia care unit (PACU), 30-day complication rates (1.7 vs 1.9%; p = 1), hospital charges, or cost between the two groups. Conclusions Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.

AB - Background Single-incision laparoscopic cholecystectomy (SILC) may be a comparable alternative to conventional multiport laparoscopic cholecystectomy (LC). This study compared procedural outcomes and costs between SILC and LC. Methods A retrospective review of patients undergoing SILC over an 8-month period was performed. A cohort of LC patients from the same surgeons over the preceding 8 months was used as historic controls. Demographics, comorbidities, diagnosis, operative data, pain control in the recovery room, complications, length of hospital stay, and cost were compared between the two groups. Results Of the 285 patients, 177 underwent LC and 108 underwent SILC. The mean age was 49.7 years for the LC patients and 48.2 years for the SILC patients (p = 0.44). Two of the LC patients underwent conversion to open surgery. None of SILC patients were converted to open procedure, although nine had additional ports placed. After multivariate adjustment, SILC was associated with a 15% longer operative time (p = 0.053) and a 66% shorter hospital stay (p = 006) than LC. Biliary dyskinesia and biliary colic were independently associated with shorter operative times and a reduced hospital stay. No significant differences were noted in pain score, narcotics used in the postanesthesia care unit (PACU), 30-day complication rates (1.7 vs 1.9%; p = 1), hospital charges, or cost between the two groups. Conclusions Single-incision LC is safe, significantly reduces the hospital stay, and is an acceptable alternative to traditional LC. Although further study is warranted, initial results indicate that SILC may offer the most benefit for outpatient procedures.

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KW - Gallbladder

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