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 lk; Choi, In Seok
- Issue Date
- 2021
- Publisher
- SPRINGER
- Keywords
- Single-incision laparoscopic cholecystectomy; Surgical indication; Acute cholecystitis; Postoperative complication
- Citation
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, v.35, no.6, pp.3025 - 3032
- Indexed
- SCIE
SCOPUS
- Journal Title
- SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
- Volume
- 35
- Number
- 6
- Start Page
- 3025
- End Page
- 3032
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/130126
- DOI
- 10.1007/s00464-020-07748-5
- ISSN
- 0930-2794
- Abstract
- Background Although single-incision laparoscopic cholecystectomy (SILC) is a common procedure, the change in its surgical indications and perioperative outcomes has not been analyzed. Methods We collected the clinical data of patients who underwent pure SILC in 9 centers between 2009 and 2018 and compared the perioperative outcomes. Results 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.
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