Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

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Is the Routine Use of Drainage After Elective Laparoscopic Cholecystectomy Justified? A Randomized Trial

Journal of Laparoendoscopic & Advanced Surgical Techniques ◽

10.1089/lap.2010.0003 ◽

2011 ◽

Vol 21 (2) ◽

pp. 119-123 ◽

Cited By ~ 20

Author(s):

Chrysanthos Georgiou ◽

Nicoleta Demetriou ◽

Theodoros Pallaris ◽

Theodosis Theodosopoulos ◽

Klea Katsouyanni ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Randomized Trial ◽

Elective Laparoscopic Cholecystectomy

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Comparative study of standard laparoscopic cholecystectomy and single incision laparoscopic cholecystectomy: outcome and complications

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20195007 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4310

Author(s):

Kirti Savyasacchi Goyal ◽

Maneshwar Singh Utaal ◽

Pramod Kumar Bhatia

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Operative Time ◽

Gall Bladder Disease ◽

Single Incision ◽

Intraoperative Complications ◽

Single Incision Laparoscopic Surgery ◽

Bladder Disease ◽

Standard Laparoscopic Cholecystectomy ◽

Single Incision Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy (LC) has evolved to be as gold standard treatment for gall bladder disease and is the most common laparoscopic procedure performed worldwide. In recent times, the innovative techniques of Natural orifice Transluminal Endoscopic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS) have been applied as a step forward towards scar less surgery with added benefits of less pain and less analgesic requirement, shorter hospital stay, quick return to work.Methods: A retrospective study of 50 patients admitted with gall bladder disease through outdoor for laparoscopic cholecystectomy from November 2018 to January 2019 in Maharishi Markandeshwar Institute of Medical Sciences and Research Mullana (AMBALA) were randomized into two groups of 25 each for Single Incision Laparoscopic Cholecystectomy (SILC) and standard laparoscopic cholecystectomy (LC) comparing the operative time, outcome and complications.Results: 50 patients admitted to MMIMSR Mullana from November 2018 to January 2019 with gall bladder disease were divided into two groups of 25 each who underwent three port SILC and four port laparoscopic cholecystectomy (4PLC). The average intra-operative time in SILC (80.56 mins) was significantly more than standard laparoscopic cholecystectomy. The average length of stay in the hospital for SILC was 1.8 days (1-3 days), was significantly less than in standard four port laparoscopic cholecystectomy. Incidence of Intraoperative complications were more in SILC than standard LC.Conclusions: SILC as the newer novel technique had better outcomes in terms of cosmesis, early discharge, shorter stay at hospital.

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