[Comparison of operative techniques in single-incision laparoscopic cholecystectomy: suture-suspension versus three-device method].

OBJECTIVE: To compare the operative techniques of single-incision laparoscopic cholecystectomy (SILC) via suture-suspension versus three-device method. METHODS: Retrospective analysis was performed for a total of 300 patients undergoing umbilical single-incision laparoscopic cholecystectomy from June 2008 to November 2011 at our hospital. The procedures were of suture-suspension (n = 200) and three-device (n = 100). Operative duration, estimated intra-operative blood loss, exposure extent of Calot's triangle, postoperative pain score, hospital stay and complications were compared respectively between two groups. Both groups were matched for age, gender, body mass index (BMI), diagnoses and American Society of Anesthesiology (ASA) class. RESULTS: All procedures were completed by the same surgeon. Comparison between two groups showed insignificant differences in blood loss (mean: (15.6 ± 9.5) vs (16.8 ± 7.4) ml; t = 1.266, P = 0.207), postoperative complications (number of case, incision contusion:4 vs 2, P = 1.000;incision hemorrhage:2 vs 2, P = 0.603) and hospitalization duration (mean: (1.6 ± 0.5) vs (1.6 ± 0.5) d; t = 0.653, P = 0.514), but significant differences in operative duration (mean:(40.5 ± 16.0) vs (51.5 ± 18.0) min; t = 5.381, P = 0.000), postoperative pain (mean: 2.0 ± 1.7 vs 3.7 ± 1.6; t = 8.324, P = 0.000) and exposure of Calot's triangle (number of case, 197 vs 68; χ(2) = 60.178, P = 0.000). Thus the suture-suspension method was superior to the three-device counterpart. CONCLUSION: The suture-suspension method of SILC is safe, economic and easy-to-handle in clinical practice.