Laparoscopic, three-port and SILS cholecystectomy: a retrospective study
Agrusa A., Romano G., Cucinella G., Cocorullo G., Bonventre S., Salamone G., Di Buono G., De Vita G., Frazzetta G., Chianetta D., Sorce V., Bellanca G., Gulotta G.
Introduction. The aim of this study was to compare the results of classic laparoscopic, three-port and SILS cholecystectomy.
Materials and methods. We conducted a retrospective study of data collected between January 2010 and December 2012 pertaining to 159 selected patients with symptomatic gallstones. 57 underwent laparoscopic cholecystectomy, 51 three-port cholecystectomy and 48 SILS cholecystectomy. We then compared the groups with respect to mean operating time, intraoperative complications, postoperative pain, duration of hospitalization and final aesthetic result.
Results. The mean operating time was significantly higher in the SILS cholecystectomy group (93 minutes) than in the other two groups. There were no intraoperative complications. There were no significant differences in the duration of hospitalization among the three groups. Patients in the SILS cholecystectomy group reported significantly less pain 3, 6 and 12 hours after surgery. The aesthetic results at 1 and 6 months’ follow-up were also decidedly better.
Conclusions. On the basis of this study, SILS cholecystectomy is a feasible, safe procedure. In any case, it should be used in selected patients only and carried out by a dedicated team with strong experience in laparoscopy. The main advantages of this technique are a reduction in post-operative pain and improved aesthetic result, at the price, however, of its greater technical difficulty and longer operating times. Future studies are in any case necessary to evaluate any other benefits of this method.
