الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Laparoscopic cholecystectomy (LC) is the ‘‘gold standard’’ for treatment of symptomatic gallstone disease. Attempts at maximizing the benefits of LC have resulted in the development of Single incision LC (SILC).
The aim of this study was to compare between the four-port Laparoscopic cholecystectomy (FPLC) and the single-port Laparoscopic cholecystectomy (SPLC) as regards feasibility, safety, postoperative pain, complications and final cosmetic outcome.
In the present study 148 patients were assessed for eligibility, the inclusion criteria were fulfilled only in 80 patients. They were randomly assigned into two equal groups using the closed envelope technique, the single port laparoscopic cholecystectomy group (SPLC) and the four port laparoscopic cholecystectomy group (FPLC). Different surgical outcomes were then analyzed and compared between both groups.
There was no statistically significant difference between both study groups as regards the patients’ demographics. In the SPLC group, the procedure was successfully completed in 38 patients (95%). Two patients (5%) were excluded from further analysis, one due to conversion to laparotomy and the other due to addition of an extra trocar. On the other hand, a FPLC was successfully completed in 40 patients. The operative time in SPLC group was longer than in the FPLC group (mean: 78.0 Vs 53.0 minutes respectively; p=0.028). The median Abdominal Wall Time constituted 33.2% of the total operative time in the SPLC group compared to 24.8% in the FPLC group with this difference being statistically significant (<0.001). The median total operative time significantly decreased with the increase of the learning curve. No early postoperative complications were encountered in both study groups. Neither common bile duct injuries nor bile leaks were encountered in the present study. The overall 24-hours median pain score was statistically significantly lower in the SPLC group (p<0.001). This was reflected by the decreased analgesic requirements especially 6 hours postoperatively. The difference in the median patient satisfaction score between both study groups was significantly higher in the SPLC group (p<0.001), where in the SPLC group, the patient satisfaction score ranged from 8-10 with a median of 10, while in the FPLC group it ranged from 7-10 with a median of 8. The median follow-up duration in the SPLC group was 34 months compared to 32.5 months in the FPLC group. Throughout the follow-up, only one patient (2.5%) in the SPLC group who developed port site hernia 6 months post-operatively.
The present study showed that single port laparoscopic cholecystectomy is an applicable, safe and efficient technique. Furthermore, it is associated with less post-operative pain and better cosmetic outcome compared to conventional four port laparoscopic cholecystectomy.