Page 27 - Peer Reviewed Laparoscopic Jornal

WJOLS

10.5005/jp-journals-10033-1189
SYSTEMATIC REVIEW A Review of Randomized Controlled Trials comparing Single Port Laparoscopic Cholecystectomy
A Review of Randomized Controlled Trials comparing

Single Port Laparoscopic Cholecystectomy with

Conventional Laparoscopic Cholecystectomy

Chukwuemeka Chukwunwendu Osuagwu

9
ABSTRACT physical activity as well as comparative levels of patient
Aim: To determine the safety and benefits of single port safety. During conventional, traditional, four-port
laparoscopic cholecystectomy. laparoscopic cholecystectomy complementary procedures,
Materials and methods: A search for randomized controlled such as laparoscopic intraoperative cholangiography using
10
trials comparing single port laparoscopic cholecystectomy with contrast may be performed to define the extrahepatic
conventional laparoscopic cholecystectomy was conducted biliary anatomy and determine the presence of common bile
using Google scholar, HighPress and SCOPUS.
duct stone. Some authors have also performed transcystic
Results: Single port laparoscopic cholecystectomy has a longer duct balloon dilatation of sphincter of Oddi during
operating time, with equivocal postoperative pain, and offers
better cosmetic result with low morbidity. conventional laparoscopic cholecystectomy which is
effective in flushing common bile duct stones into the
Conclusion: Single port laparoscopic cholecystectomy is at
least as safe as conventional laparoscopic cholecystectomy in duodenum in 85% of cases. 11
carefully selected patients. In 1997, Navarra performed the first single incision
12
Keywords: Single incision laparoscopic cholecystectomy, laparoscopic cholecystectomy. Single incision laparos-
Conventional laparoscopy, Randomized controlled trial. copic cholecystectomy also goes by other terminologies,
How to cite this article: Osuagwu CC. A Review of such as transumbilical laparoscopic cholecystectomy, 13
Randomized Controlled Trials comparing Single Port single port laparoscopic cholecystectomy, natural orifice
14
Laparoscopic Cholecystectomy with Conventional Laparoscopic 15
Cholecystectomy. World J Laparosc Surg 2013;6(2):93-97. transumbilical surgery (NOTUS) cholecystectomy and
16
laparoendoscopic single site (LESS) cholecystectomy. The
Source of support: Nil
popularity of single incision laparoscopic surgery is driven
Conflict of interest: None declared
17
by reports of improved cosmesis, further reduction in
INTRODUCTION postoperative pain alongside comparative safety. 18
However, there are difficulties with swording of instruments
Gallstone disease is a common surgical condition. Everhart and loss of triangulation as well as increased operating
19
et al in a national survey in the United States found that time, and port site hernia, and increased risk of conversion.
6.3 million men and 14.2 million women who were within The safety of single port laparoscopic cholecystectomy
the age range of 20 to 74 years were afflicted with should be determined compared with the standard of
gallbladder disease. Gallstone disease is a least twice as care as recent reports suggest that advanced procedures,
1
common in females as in males. In Europe, the prevalence such as laparoscopic cholangiography is being undertaken
was found to vary from 5.9% in Italy to 21.9% in Norway. 2 during single port laparoscopic cholecystectomy with
The incidence rate in Europe is about 0.63 to 0.93/100 some success. 20,21 Therefore, it is necessary to review
3,4
persons/year which may reflect the increasing demand randomized control trials that compared the single port
for cholecystectomy. In Taiwan, a lower prevalence of laparoscopic cholecystectomy with the four-port laparos-
gallstone disease was noted 4.6% in men and 5.4% in copic cholecystectomy.
women; however, there was no difference in sex prevalence. 5
In Africa, a hospital prevalence of 747 cases in 4 years with AIM
a male to female ratio of 1:5 was also reported. 6 To compare safety of single incision laparoscopic chole-
Cholecystectomy is the proven treatment for cystectomy with conventional laparoscopic cholecystectomy
6
symptomatic gallstone disease. Open cholecystectomy is with emphasis on the operating time, postoperative pain,
the mainstay of surgical treatment of gallbladder disease; and cosmesis (Table 1), and bile duct injuries as well as
however, it has evolved in terms of the access to the conversion rate.
gallbladder. Muhe in 1985 introduced laparoscopic
7
cholecystectomy, which subsequently, became the gold MATERIALS AND METHODS
8
standard of care because it offered better cosmetic outcome, A search of published randomized controlled trails
reduced postoperative pain with early return to normal comparing single port laparoscopic cholecystectomy with
World Journal of Laparoscopic Surgery, May-August 2013;6(2):93-97 93