Risk factors for prolonged operative time in single-incision laparoscopic cholecystectomy.
10.4174/astr.2015.89.5.247
- Author:
Seong Uk CHEON
1
;
Ju Ik MOON
;
In Seok CHOI
Author Information
1. Department of Surgery, Konyang University Hospital, Konyang University School of Medicine, Daejeon, Korea. monjuik@naver.com
- Publication Type:Original Article
- Keywords:
Operative time;
Risk factors;
Cholecystectomy;
Laparoscopy;
Single incision
- MeSH:
Body Mass Index;
Cholecystectomy;
Cholecystectomy, Laparoscopic*;
Cholecystitis;
Cholecystitis, Acute;
Drainage;
Empyema;
Gallbladder;
Gallbladder Diseases;
Humans;
Laparoscopy;
Multivariate Analysis;
Operative Time*;
Professional Competence;
Risk Factors*;
Snakes
- From:Annals of Surgical Treatment and Research
2015;89(5):247-253
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We performed 3-channel single incision laparoscopic cholecystectomy (SILC) in earlier period of this study and modified our method to 4-channel SILC using a snake retractor for better operative field in later period. This study has been designed to evaluate the risk factors for prolonged operative time in SILC. METHODS: From April 2010 to August 2014, 323 cases of 3-channel SILC (Konyang standard method [KSM] group) and 399 cases of 4-channel SILC (modified KSM [mKSM] group) using a snake retractor were performed. RESULTS: The clinical characteristics were not significantly different between KSM and mKSM group except preoperative percutaneous transhepatic gallbladder drainage (PTGBD) treatment (9.6% vs. 16.5%, P < 0.007). The mean operation time was longer in mKSM group than KSM group (55.8 +/- 19.7 minutes vs. 51.7 +/- 20.1 minutes, P = 0.006). The estimated blood loss of KSM group was more than mKSM group (24.6 +/- 54.1 mL vs. 16.9 +/- 27.0 mL, P = 0.013). According to the histopathologic findings, acute cholecystitis or empyema were confirmed more in mKSM group as compared with KSM group (28% vs. 14.0%, P = 0.025). In multivariate analysis, the risk factors for prolonged operation time were drainage insertion, histopathologic findings (acute cholecystitis or empyema), surgeons' technical expertise, body mass index > 30 kg/m2 as well as the 4-channel SILC. CONCLUSION: Among patients with these risk factors, conventional laparoscopic cholecystectomy could be considered as well although SILC might be safe and feasible modality for benign gallbladder disease.
