Comparative Study of Single Incision Laparoscopic Cholecystectomy with Standard Four Port Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

Ashok Koirala; Ruslan Sulaimankulov; Dipendra Thakur; Sunit Agrawal; Bhuwan Lal Chaudhary; Sagar Poudel

Ashok Koirala Department of General and Minimally Invasive Surgery, NMCTH, Biratnagar
Ruslan Sulaimankulov Department of General and Minimally Invasive Surgery, NMCTH, Biratnagar
Dipendra Thakur Department of General and Minimally Invasive Surgery, NMCTH, Biratnagar
Sunit Agrawal Department of Surgery, B.P. Koirala Institute of Health Science, Dharan
Bhuwan Lal Chaudhary Department of General and Minimally Invasive Surgery, NMCTH, Biratnagar
Sagar Poudel Department of General and Minimally Invasive Surgery, NMCTH, Biratnagar

Abstract

Introduction: Laparoscopic cholecystectomy is gold standard treatment for symptomatic gall stone diseases. Conventionally, it is performed by standard four port technique. Recently, single incision laparoscopic cholecystectomy (SILC) is increasingly being used which is newly developed technique. The aim of this study is to compare the outcome of standard four port laparoscopic cholecystectomy versus single incision laparoscopic cholecystectomy (SILC).

Methods: The study was prospective study conducted in Nobel Medical College Teaching Hospital (NMCTH), Biratnagar. Total 200 patients with diagnosis of symptomatic cholelithiasis admitted through OPD of our hospital were included in the study. The patients were equally divided in two equal groups: 100 in standard four port laparoscopic cholecystectomy (Group A) and 100 in single incision laparoscopic cholecystectomy (Group B) .All age groups and both sexes were included.

Results: Out of 200 patients with symptomatic cholelithiasis, Mean age of the patients in Group A was 41.65±14.37 years and that in Group B was 40.29 ± 14.15years [p=0.500]. The mean operative time in Group A was 37.81±8.39 minutes where as in Group B it was 32.75±7.52 minutes[p<0.001].The mean postoperative pain at 8 hours in Group A was 8.34 ±0.97 and in Group B 8.66 ±0.81[p=0.012], at day one Group A5.45±1.12 and in Group B5 .94±1.29 [p=0.005], at day two Group A 3.74±1.13 and in Group B4.18±1.34[p=0.013].Mean duration of Hospital stay in Group A was 2.39±0.65 and in Group B 2.64±0.67 [p=0.008].In two weeks and subsequent 3 months follow up period, scar look cosmetically better in SILC.

Conclusion: Single incision laparoscopic cholecystectomy is almost comparable with four port laparoscopic cholecystectomy; however, single incision laparoscopic cholecystectomy will be better options for patients concerned about cosmetics.

Keywords: Four port laparoscopic cholecystectomy; single incision laparoscopic cholecystectomy (SILC); symptomatic gall stone disease