Comparison of Single-Incision Laparoscopic Surgery (SILC) Versus Conventional Multi-Port Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy is the standard treatment for symptomatic cholelithiasis, and single-incision laparoscopic cholecystectomy (SILC) has been introduced to reduce access trauma and improve cosmetic outcomes; however, evidence remains inconsistent regarding its comparative benefits and wound morbidity. Objective: To compare operative and postoperative outcomes of single-incision laparoscopic cholecystectomy (SILC) versus conventional multi-port laparoscopic cholecystectomy (CMLC) in patients with uncomplicated symptomatic cholelithiasis. Methods: This randomized controlled trial was conducted at the surgical department of Jinnah Hospital, Lahore, from August 3, 2015, to February 2, 2016. A total of 178 patients (18–80 years) were randomized by lottery method into Group A (SILC, n=89) and Group B (CMLC, n=89). Outcomes included operative time, hospital stay, postoperative pain (VAS) immediately and at 24 hours, and wound infection at postoperative day 7 and day 30. Results: Operative time was longer in SILC (65.73±13.48 vs 50.61±9.38 minutes; p<0.001), while hospital stay was shorter (1.11±0.32 vs 1.91±0.87 days; p<0.001). SILC had lower pain immediately (3.16±0.78 vs 4.72±1.07; p<0.001) and at 24 hours (1.67±0.65 vs 3.42±0.77; p<0.001). Wound infection was higher with SILC at day 7 (16.9% vs 5.6%; p=0.018) and day 30 (10.1% vs 2.2%; p=0.029). Conclusion: SILC reduced early pain and length of stay but increased operative time and wound infection compared with CMLC.