Single Incision Laparoscopic Cholecystectomy vs Conventional Laparoscopic Cholecystectomy: A Meta-analysis of the literature.
EAES Academy. Portelli M. 07/05/22; 363051; P095
Mr. Mark Portelli
Contributions
Contributions
Abstract
Aims:
Minimally invasive surgery is gradually becoming the mainstay of surgical treatment. In addition to the current mainstream four port cholecystectomy, current research has looked upon the possibility of a single incision laparoscopic cholecystectomy (SILC). In this meta-analysis we aim to compare conventional multiport laparoscopic cholecystectomy (CLC) versus single incision laparoscopic cholecystectomy in terms of operative time, cosmesis and post-operative pain.
Materials and Methods: A literature search was carried out on PubMed, MEDLINE,
EMBASE and Google Scholar, using MESH terms ‘randomised controlled trial’, ’laparoscopy’, ‘single port’, ‘multi-port’ and ‘cholecystectomy’. Randomised controlled trials (RCT) comparing SILC versus CLC published between January 2010 and January 2021 were included. Data was collected on operative time, cosmesis and postoperative pain visual analog score (VAS) at 6 and 24 hours.
Results:
Seven randomised controlled trials were used. When compared to CLC, SILC has comparable operative time (Chi2 = 273.78; p<0.0.00001; CI -2.19, 24.12; I2 98%) and VAS pain score at 6 hours (Chi2 = 19.77; p<0.0001; CI -0.49, 0.15; I2 = 90%). CLC had a significantly better cosmetic outcome (Chi2 = 16.07; p<0.0003; CI 0.89, 1.38; I2 = 88%). SILC demonstrated a significantly better VAS pain score at 24 hours (Chi2 = 45.15; p<0.00001; CI -0.37, -0.02; I2 = 91%).
Conclusion:
This meta-analysis demonstrated that with the exception of improved post-operative pain at 24 hours, SILC did not show improved outcomes when compared to CLC. With the present published RCTs we are unable to provide statistical analysis on further outcomes such as post-operative complications. Hence the choice of procedure remains largely the decision of the operating surgeon.
Minimally invasive surgery is gradually becoming the mainstay of surgical treatment. In addition to the current mainstream four port cholecystectomy, current research has looked upon the possibility of a single incision laparoscopic cholecystectomy (SILC). In this meta-analysis we aim to compare conventional multiport laparoscopic cholecystectomy (CLC) versus single incision laparoscopic cholecystectomy in terms of operative time, cosmesis and post-operative pain.
Materials and Methods: A literature search was carried out on PubMed, MEDLINE,
EMBASE and Google Scholar, using MESH terms ‘randomised controlled trial’, ’laparoscopy’, ‘single port’, ‘multi-port’ and ‘cholecystectomy’. Randomised controlled trials (RCT) comparing SILC versus CLC published between January 2010 and January 2021 were included. Data was collected on operative time, cosmesis and postoperative pain visual analog score (VAS) at 6 and 24 hours.
Results:
Seven randomised controlled trials were used. When compared to CLC, SILC has comparable operative time (Chi2 = 273.78; p<0.0.00001; CI -2.19, 24.12; I2 98%) and VAS pain score at 6 hours (Chi2 = 19.77; p<0.0001; CI -0.49, 0.15; I2 = 90%). CLC had a significantly better cosmetic outcome (Chi2 = 16.07; p<0.0003; CI 0.89, 1.38; I2 = 88%). SILC demonstrated a significantly better VAS pain score at 24 hours (Chi2 = 45.15; p<0.00001; CI -0.37, -0.02; I2 = 91%).
Conclusion:
This meta-analysis demonstrated that with the exception of improved post-operative pain at 24 hours, SILC did not show improved outcomes when compared to CLC. With the present published RCTs we are unable to provide statistical analysis on further outcomes such as post-operative complications. Hence the choice of procedure remains largely the decision of the operating surgeon.
Aims:
Minimally invasive surgery is gradually becoming the mainstay of surgical treatment. In addition to the current mainstream four port cholecystectomy, current research has looked upon the possibility of a single incision laparoscopic cholecystectomy (SILC). In this meta-analysis we aim to compare conventional multiport laparoscopic cholecystectomy (CLC) versus single incision laparoscopic cholecystectomy in terms of operative time, cosmesis and post-operative pain.
Materials and Methods: A literature search was carried out on PubMed, MEDLINE,
EMBASE and Google Scholar, using MESH terms ‘randomised controlled trial’, ’laparoscopy’, ‘single port’, ‘multi-port’ and ‘cholecystectomy’. Randomised controlled trials (RCT) comparing SILC versus CLC published between January 2010 and January 2021 were included. Data was collected on operative time, cosmesis and postoperative pain visual analog score (VAS) at 6 and 24 hours.
Results:
Seven randomised controlled trials were used. When compared to CLC, SILC has comparable operative time (Chi2 = 273.78; p<0.0.00001; CI -2.19, 24.12; I2 98%) and VAS pain score at 6 hours (Chi2 = 19.77; p<0.0001; CI -0.49, 0.15; I2 = 90%). CLC had a significantly better cosmetic outcome (Chi2 = 16.07; p<0.0003; CI 0.89, 1.38; I2 = 88%). SILC demonstrated a significantly better VAS pain score at 24 hours (Chi2 = 45.15; p<0.00001; CI -0.37, -0.02; I2 = 91%).
Conclusion:
This meta-analysis demonstrated that with the exception of improved post-operative pain at 24 hours, SILC did not show improved outcomes when compared to CLC. With the present published RCTs we are unable to provide statistical analysis on further outcomes such as post-operative complications. Hence the choice of procedure remains largely the decision of the operating surgeon.
Minimally invasive surgery is gradually becoming the mainstay of surgical treatment. In addition to the current mainstream four port cholecystectomy, current research has looked upon the possibility of a single incision laparoscopic cholecystectomy (SILC). In this meta-analysis we aim to compare conventional multiport laparoscopic cholecystectomy (CLC) versus single incision laparoscopic cholecystectomy in terms of operative time, cosmesis and post-operative pain.
Materials and Methods: A literature search was carried out on PubMed, MEDLINE,
EMBASE and Google Scholar, using MESH terms ‘randomised controlled trial’, ’laparoscopy’, ‘single port’, ‘multi-port’ and ‘cholecystectomy’. Randomised controlled trials (RCT) comparing SILC versus CLC published between January 2010 and January 2021 were included. Data was collected on operative time, cosmesis and postoperative pain visual analog score (VAS) at 6 and 24 hours.
Results:
Seven randomised controlled trials were used. When compared to CLC, SILC has comparable operative time (Chi2 = 273.78; p<0.0.00001; CI -2.19, 24.12; I2 98%) and VAS pain score at 6 hours (Chi2 = 19.77; p<0.0001; CI -0.49, 0.15; I2 = 90%). CLC had a significantly better cosmetic outcome (Chi2 = 16.07; p<0.0003; CI 0.89, 1.38; I2 = 88%). SILC demonstrated a significantly better VAS pain score at 24 hours (Chi2 = 45.15; p<0.00001; CI -0.37, -0.02; I2 = 91%).
Conclusion:
This meta-analysis demonstrated that with the exception of improved post-operative pain at 24 hours, SILC did not show improved outcomes when compared to CLC. With the present published RCTs we are unable to provide statistical analysis on further outcomes such as post-operative complications. Hence the choice of procedure remains largely the decision of the operating surgeon.
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