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- Title
The chronological change of indications and outcomes for single-incision laparoscopic cholecystectomy: a Korean multicenter study.
- Authors
Lee, Woohyung; Roh, Young Hoon; Kang, Sung Hwa; Kim, Chung Yun; Choi, YoungRok; Han, Ho-Seong; Han, Hyung Joon; Song, Tae-Jin; Kang, Chang Moo; Lee, Woo Jung; Choi, Sung Hoon; Jeong, Sung Yub; Hong, Tae Ho; You, Young Kyoung; Lee, Jae Hoon; Moon, Ju Ik; Choi, In Seok
- Abstract
<bold>Background: </bold>Although single-incision laparoscopic cholecystectomy (SILC) is a common procedure, the change in its surgical indications and perioperative outcomes has not been analyzed.<bold>Methods: </bold>We collected the clinical data of patients who underwent pure SILC in 9 centers between 2009 and 2018 and compared the perioperative outcomes.<bold>Results: </bold>In this period, 6497 patients underwent SILC. Of these, 2583 were for gallbladder (GB) stone (39.7%), 774 were for GB polyp (11.9%), 994 were for chronic cholecystitis (15.3%), and 1492 were for acute cholecystitis (AC) (23%). 162 patients (2.5%) experienced complication, including 20 patients (0.2%) suffering from biliary leakage. The number of patients who underwent SILC for AC increased over time (p = 0.028), leading to an accumulation of experience (27.4 vs 23.7%, p = 0.002). The patients in late period were more likely to have undergone a previous laparotomy (29.5 vs 20.2%, p = 0.006), and to have a shorter operation time (47.0 vs 58.8 min, p < 0.001). Male (odds ratio [OR]; 1.673, 95% confidence interval [CI] 1.090-2.569, p = 0.019) and moderate or severe acute cholecystitis (OR; 2.602, 95% CI 1.677-4.037, p < 0.001) were independent predictive factors for gallbladder perforation during surgery, and open conversion (OR; 5.793, 95% CI 3.130-10.721, p < 0.001) and pathologically proven acute cholecystitis or empyema (OR; 4.107, 95% CI 2.461-6.854, p < 0.001) were related with intraoperative gallbladder perforation CONCLUSION: SILC has expanded indication in late period. In this period, the patients had shorter operation times and a similar rate of severe complications, despite there being more numerous patients with AC.
- Subjects
SOUTH Korea; SURGICAL indications; CHOLECYSTECTOMY; LAPAROSCOPIC surgery; EMPYEMA; ODDS ratio; GALLBLADDER; GALLSTONES; RESEARCH; RESEARCH methodology; CHOLECYSTITIS; MEDICAL cooperation; EVALUATION research; TREATMENT effectiveness; COMPARATIVE studies
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2021, Vol 35, Issue 6, p3025
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-020-07748-5