Analysis of Intraoperative Findings During Single Port Laparoscopic Cholecystectomy

Hyung Joon Han, MD, Sae Byeol Chi, MD, Jin-suk Lee, MD, Young Dong Yu, MD, Cheol Woong Jung, MD FACS, Wan-bae Kim, MD, Dong-sik Kim, MD, Tae Jin Song, MD FACS, Sung Ock Suh, MD, Sang Yong Choi, MD. Korea University Medical Center

 Background
Single Port Laparoscopic Cholecystectomy displays substantial progresses in minimally invasive surgery and recent randomized controlled studies of this novel technique have challenged the conventional laparoscopic cholecystectomy as the gold standard treatment in benign gallbladder disease.
Herein, we analyze our clinical outcomes and operative findings of single port laparoscopic cholecystectomy in order to give some better opinions about selecting patients who will undergo single port laparoscopic cholecystectomy.
Methods
We analyzed the operative findings and clinical parameters patients who underwent single port laparoscopic cholecystectomy using logistic regression method to find significant variables of influencing postoperative results.
Results
Between Jan 2009 and Sep 2011, 203 patients were underwent single port laparoscopic cholecystectomy. The patients with higher body mass index (>25 kg/m2; p=0.026; odd ratio, 3.451; 95% confidence interval, 1.161-10.256) and acute cholecystitis (p=0.050; OR, 5.437; 95% CI, 0.948-31.190) have higher complication rates. Longer operation time was observed in patients with intraoperative bile leakage (p=0.034; OR, 1.010; 95% CI, 1.001-1.020) and adhesions around gallbladder (p=0.019; OR, 1.014; 95% CI 1.002-1.027). Single port laparoscopic cholecystectomies using four instruments were frequently performed in patients with gallbladder distention (p=0.018; OR, 5.920; 95% CI, 1.351-25.928) and adhesions (p=0.005; OR, 8.448; 95% CI, 1.888-37.802).
Conclusion
Single port laparoscopic cholecystectomy is feasible and safe in selected patients. We recommend avoiding the patients with higher body mass index, acute cholecystitis, bile leakage, gallbladder distention or adhesions around gallbladder.

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