Single-Port Cholecystectomy for Cholecystitis Versus Non-Cholecystitis

Background and Objectives: To assess the safety and efficacy of single-port laparoscopic cholecystectomy (SPLC) for the treatment of symptomatic cholelithiasis in different gallbladder pathologic conditions.Methods: All patients who underwent SPLC in our department between October 1, 2017 and March 31, 2020 were registered consecutively in a prospective database. Patients' charts were retrospectively divided according to histological diagnosis: normal gallbladder (NG) (n = 13), chronic cholecystitis (CC) (n =47), and acute cholecystitis (AC) (n = 10). The parameters for assessing the procedure outcome included operative time, blood loss, use of additional trocars, conversion to laparotomy, intraoperative and postoperative com-plications, and length of hospital stay. Patient groups were statistically compared.Results: Seventy patients underwent SPLC. Duration of sur-gery increased from NG (55 +/- 22.7 min) to CC (70 +/- 33.5 min), and to AC patients (110.5 +/- 50.5 min), which is statistically significant symbolscript .001). Postoperative complication rates were 7.6% in NG patients, 17% in CC, and 30% in AC symbolscript .442). Length of hospitalization was shorter for NG patients (1.0 +/- 0.6 days) versus CC (2.0 +/- 1.1 days) and AC patients (2.0 +/- 4.7 days), with statistical significance symbolscript .020). Multivariate analysis found that pathology type and the occurrence of postoperative complications were inde-pendent predictors for prolonged operative times and pro-longed hospital stay, respectively.Conclusion: SPLC is feasible for acute and chronic cholecys-titis with good procedural outcomes. Since SPLC technique itself can be sometimes challenging with the existing technol-ogy, its application, especially in cases of acute cholecystitis, should be done with caution. Only prospective randomized studies on this approach for acute and chronic gallbladder dis-eases will assess the complete reliability of this technique.