Classic Laparoscopy Technique Preferred for Gallbladder Surgery

Procedure times are longer and complications more frequent with single-port laparoscopic cholecystectomy than with the traditional four-port technique, according to a new study.

Researchers at Providence Portland Medical Center (OR, USA) conducted a study to compare short-term surgical outcomes and quality of life (QOL) in 43 eligible patients randomized to single-port laparoscopic cholecystectomy (SPLC, 21 patients) and classic 4-port laparoscopic cholecystectomy (CLC, 22 patients). There were no significant differences between groups for most preoperative demographics, American Society of Anesthesiology (ASA) score, gallstone characteristics, local inflammation, blood loss, or length of stay.

The results showed that patients undergoing SPLC were older than those receiving CLC (57.3 years versus 45.8 years). Operative times for SPLC were greater than CLC; overall and cosmetic satisfaction, QOL as determined by the SF-36 survey, postoperative complications, and post-operative pain scores between discharge and two-week postoperative visit were not significantly different between groups. Wound infection rates were also similar in both groups. The SPLC group contained one retained bile duct stone, one port site hernia, and one postoperative port site hemorrhage. The study was published on April 13, 2011, in Annals of Surgery.

"In summary, on the basis of our randomized controlled trial, single-port laparoscopic cholecystectomy had a longer operative time and seemed to incur more postoperative complications, which may be related to the learning curve," concluded lead author Paul Hansen, MD, and colleagues of the hepatobiliary and pancreatic surgery program. "However, both single-port laparoscopic cholecystectomy and classic laparoscopic cholecystectomy produced similar levels of patient satisfaction and pain, as well as patient-perceived functional health status."

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Providence Portland Medical Center