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Single-Incision Versus Conventional Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis
Current Issue
Volume 2, 2014
Issue 5 (October)
Pages: 103-118   |   Vol. 2, No. 5, October 2014   |   Follow on         
Paper in PDF Downloads: 12   Since Aug. 28, 2015 Views: 2168   Since Aug. 28, 2015
Authors
[1]
Jie Hua, Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University of Medicine, Shanghai, China; First Clinical Medical College of Nanjing Medical University, Nanjing, China.
[2]
Jian Gong, Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University of Medicine, Shanghai, China.
[3]
Le Yao, Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University of Medicine, Shanghai, China.
[4]
Zhenshun Song, Department of General Surgery, Shanghai Tenth People’s Hospital, Tongji University of Medicine, Shanghai, China.
Abstract
Background: This review aims to evaluate the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) as compared to conventional laparoscopic cholecystectomy (CLC). Methods: A literature search for studies comparing the feasibility and safety of SILC with CLC was performed. Perioperative complications, postoperative pain, cosmetic satisfaction, conversion rates operative time, length of stay (LOS), estimated blood loss (EBL), total incision length, time to return to work / normal activity, and cost of stay were extracted. Weighted mean differences (WMDs) and odds ratios (ORs) were calculated for continuous and dichotomous variables, respectively. Results: Forty-three studies, including 2291 cases for SILC and 2281 cases for CLC, were included. Our analysis showed that compared with CLC, SILC was associated with significantly reduced postoperative pain on the day of surgery (WMD, -0.47; p = 0.005), lower rate of analgesic use (26.5% vs. 36.1%; p = 0.004), better cosmetic satisfaction scores (WMD, 0.84; p = 0.0006), shorter LOS (WMD, -0.18d; p = 0.03), and shorter incision length (WMD, -9.67 mm; p = 0.004). However, SILC was associated with significantly longer operative time compared to CLC (WMD, 13.65min; p < 0.00001). No significant differences were observed in perioperative complications, analgesic requirement, conversions to open surgery, EBL, time to return to work / normal activity, or cost of stay. Conclusions: In this analysis, which included the largest number of patients thus far, SILC appeared to be feasible and safe. Whether SILC benefits LOS over CLC remains to be further investigated, as well as cost of stay.
Keywords
Laparoscopic Cholecystectomy, Single-Incision, Single-Port Access, Laparoendoscopic Single-Site, Single-Incision Laparoscopic Surgery
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