Quality of life after single port laparoscopic cholecystectomy: a randomized clinical trial

Abstract

Results: Preoperative characteristics of patients and disease were comparable between MILS and Open Group. Laparoscopic series resulted in a statistically significant lower blood loss (200 vs 350, p=0.03), minor intraoperative blood transfusions (3.2% vs 7.9%, p=0.04) and postoperative blood transfusions (10.5% vs 15.8%), other than shorter lenght of stay (4 vs 6 days, p=0.04). Number of retrieved nodes was 8 vs 7 (p=ns); particularly, percentage of patients who achieved the recommended AJCC cutoff of six lymph nodes harvested were 93.7% vs 85.8% (p=0.05). Morbidity was lower in MILS group (16.8% vs 22.1%, p=0.02). Median disease free survival was 33 vs 36 months and disease recurrence occurred in 45.3% vs 55.3% of patients in MILS and Open Groups respectively. Conclusion: Laparoscopic approach for lymphadenectomy is a valid option in patients with biliary cancers since it allows to maintain the advantages of minimally invasive approach, without compromising the accuracy and the outcomes of nodal dissection.

Artificial Intelligence-Based Inferior Vena Cava Images under Dezocine Anesthesia in Detection of Bile Duct Injury after Laparoscopic Cholecystectomy

“…It can also arise from objective reasons. For example, laparoscopy technology itself has certain limitations; when operations are performed on the screen, it is sometimes difficult to determine the accurate anatomical position, because the surgeon cannot directly touch the operation area; and obese patients will also affect the surgical field of vision to a certain extent [20][21][22]. In addition, changes in the shape and position of the gallbladder will increase the risk of BDI [23].…”

Long-term follow up of single-incision laparoscopic cholecystectomy compared to conventional laparoscopic cholecystectomy

“…However, SILC has not gained widespread acceptance possibly because it is a more technically challenging operation than CLC [7,22]. Additionally, SILC has been associated with longer procedure times and more complications, without signifi cant benefi t in terms of patients' satisfaction, postoperative pain, and quality of life [7,19,22]. This was likely attributed to the technical diffi culties faced during the procedure which include instrument clashing, reduced visibility, and reduced mobility of instruments.…”

“…Numerous studies have shown that SILC offers better cosmesis, reduced postoperative pain, lesser complications and faster recovery time compared to CLC [4,[10][11][12]. However, SILC has not gained widespread acceptance due to increased operative time (57.8mins versus 35.2mins), technical diffi culty, minimal cosmetic benefi t and analgesia benefi t, and increased incisional hernia rates (13.3% versus 4.7%) [4,7,9,10,[13][14][15][16][17][18][19].…”