Single-incision laparoscopic cholecystectomy in children: a feasible alternative to the standard laparoscopic approach

Purpose: Our aim was to evaluate the outcomes of the single-incision laparoscopic (SIL) cholecystectomy compared with the standard 4-incision laparoscopic (SL) cholecystectomy. Methods: A retrospective chart review of consecutive patients undergoing cholecystectomy using the SIL approach from January 2008 to September 2010 was performed. These patients were compared with a cohort who underwent an SL cholecystectomy from January 2007 to June 2009. Demographics, operative times, length of stay, blood loss, and intravenous narcotic use was obtained from the charts. A nonpaired Student's t test was used to determine statistical significance. Results: We identified 40 patients in the SIL group and 68 in the SL group. Main diagnosis was cholelithiasis followed by gallstone pancreatitis and cholecystitis. The mean operative time for SIL cholecystectomies was 79.2 minutes vs 63 minutes in the SL group (P<.006). The average length of stay was 1.9 days in the SIL group vs 2.3 days in the SL group (P<.24). The mean intravenous narcotic use was 1 dose in the SIL group vs 2.9 doses in the SL group (P<.007). There were no intraoperative complications. At 1-month postoperative follow-up, all patients had satisfactory recovery. Conclusion: Single-incision laparoscopic cholecystectomy is a safe and feasible alternative to the standard laparoscopic approach in children, even in the setting of acute disease. (C) 2011 Elsevier Inc. All rights reserved.