Feasibility and safety of single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy in an ambulatory setting

Background: Single-incision laparoscopic surgery has emerged as an alternative to conventional laparoscopic cholecystectomy (LC) in the clinical setting. Limited information is available on the possibility of performing single-incision laparoscopic surgery as an ambulatory procedure. This study aimed to determine the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) versus conventional LC in an ambulatory setting. Methods: Ninety-one patients were randomized to SILC (n=49) or LC (n=42). The success rate, operative duration, blood loss, hospital stay, gallbladder perforation, drainage, delayed discharge, readmission, total cost, complications, pain score, vomiting, and cosmetic satisfaction of the two groups were then compared. Results: There were significant differences in the operative time (46.89 +/- 10.03 min in SILC vs. 37.24 +/- 10.23 min in LC; P < 0.001). As compared with LC, SILC was associated with lower total costs (8012.28 +/- 752.67 RMB vs. 10258.91 +/- 1087.63 RMB; P < 0.001) and better cosmetic satisfaction (4.94 +/- 0.24 vs. 4.74 +/- 0.54; P= 0.031). There were no significant differences between-group in terms of general data, success rate, blood loss, hospital stay, gallbladder perforation, drainage, delayed discharge, readmission, complications, pain score, and vomiting (P > 0.05). Conclusions: Ambulatory SILC is safe and feasible for selected patients. The advantages of SILC as compared with LC are improved cosmetic satisfaction and lower total costs. (C) 2019 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights reserved.