Implants médicaux et chirurgie

Abstrait

In adult patients with symptomatic cholelithiasis, does operative management with single-incision laparoscopic cholecystectomy lead to decreased postoperative complications, pain, operative time, length of hospital stay, and cosmesis when compared to multi-port laparoscopic cholecystectomy?

Jordan Brown

Background: Approximately 300,000 cholecystectomies
are performed annually in the U.S, making it one of the
10 most common surgical procedures. In the last 10 years,
new operative techniques, particularly the single-incision
approach has emerged as an alternative to the current
gold-standard, the laparoscopic cholecystectomy.
Purpose: The purpose of this analysis is to evaluate the
post-operative complications, pain, operative time, length
of hospital stay and cosmesis in patients undergoing a
single-incision laparoscopic cholecystectomy (SILC) compared
to the multi-port laparoscopic cholecystectomy
(MPLC).
Materials and Methods: Our research search utilized:
PubMed, OVID, and Google Scholar. Search terms
used were “single-port laparoscopic cholecystectomy”,
“single-incision laparoscopic cholecystectomy”, and
“cholelithiasis”. Studies were limited to those written in
English language, human participants, randomized control
trials, and comparative studies. All meta-analysis, systemic
reviews, and publications older than 10 years were
excluded. Of the 51 articles found, 20 met inclusion criteria.
In total, data from 2,777 patients between ages 18
and 85, all with symptomatic cholelithiasis, was reviewed.
Results: Most studies showed no significant difference
in post-operative pain, length of hospital stay, or postoperative
complications between both surgical techniques.
Single-incision laparoscopic cholecystectomy was found
to have overall significantly longer operative times while
also having more favorable aesthetic outcomes when
compared to multi-port laparoscopic cholecystectomy.
Conclusion: The single-incision laparoscopic cholecystectomy
offers superior cosmesis at the expense of longer
operative times. Although most of the analyzed studies
showed no significant difference in postoperative pain,
hospital stay, and postoperative complications between
the two groups, there is still conflicting data. Further research
utilizing wider populations and larger sample sizes
are needed in order to confirm both an equal safety profile
as well as feasibility between both surgical approaches
in treating symptomatic cholelithiasis.