Table 1.
English prospective randomized control trials of single-incision laparoscopic cholecystectomy vs multi-incision laparoscopic cholecystectomy retrieved online via PubMed from Jan 2012 to Feb 2015 n (%)
| Ref. | Journal (Year) | SILC, n | SILC for AC | |||
| Chang et al[71] | World J Surg (2015) | 50 | 0 | |||
| 1Pappas-Gogos et al[27] | J Surg Res (2015) | 20 | N/A | |||
| Khorgami et al[72] | J Invest Surg (2014) | 30 | 6 (20) | |||
| Jørgensen et al[73] | Br J Surg (2014) | 60 | 1 (1.7) | |||
| Deveci et al[75] | J Korean Surg Soc (2013) | 50 | 6 (12) | |||
| Noguera et al[40] | Surg Endosc (2013) | 40 (20 SILC, 20 flexible SILC) | 0 | |||
| Yilmaz et al[81] | J Korean Surg Soc (2013) | 43 | 0 | |||
| Zapf et al[76] | Surgery (2013) | 49 | 7 (14.3) | |||
| Brown et al[77] | Surg Endosc (2013) | 40 | 0 | |||
| 1Madureira et al[37] | Surg Innov (2013) | 28 | 0 | |||
| Hu et al[78] | J Laparoendosc Adv Surg Tech A (2013) | 30 | 0 | |||
| Marks et al[13] | J Am Coll Surg (2013) | 119 | 0 | |||
| Ostlie et al[96] | J Laparoendosc Adv Surg Tech A (2013) | 17 | N/A | |||
| Abd Ellatif et al[44] | Surg Endosc (2013) | 125 | 0 | |||
| Luna et al[79] | Surg Endosc (2013) | 20 | 0 | |||
| 1Madureira et al[43] | Surg Endosc (2013) | 28 | 0 | |||
| Saad et al[82] | Br J Surg (2013) | 35 | 0 | |||
| Pan et al[42] | World J Gastroenterol (2013) | 49 | 0 | |||
| Ostlie et al[80] | J Pediatr Surg (2013) | 30 | 0 | |||
| Vilallonga et al[83] | J Minim Access Surg (2012) | 69 | 14 (20.3) | |||
| 1Tsimogiannis et al[28] | Surg Endosc (2012) | 20 | N/A | |||
| MILC, n | (Para)umbilical fasciotomy | Working instrument | GB suspension | IOC | ||
| 50 | 1 large | Articulated | Suture | Nil | ||
| 20 | 1 large + 1 small | Curved | Nil | Nil | ||
| 30 3ILC + 30 4ILC | 3 small | Straight | Nil | N/A | ||
| 60 | 1 large | Roticular | Suture | 1 (1.7) | ||
| 50 | 1 large | Articulated | Suture: 17 (34) | Nil | ||
| 20 | SILC: 1 large; flexible SILC: 3 small | SILC: articulated; flexible SILC: straight | Nil | Nil | ||
| 40 | 1 large | N/A | Nil | Nil | ||
| 51 | 3 small | Articulated | Suture: 2 (4.1) | 5 (10.2) | ||
| 39 | 3 small | Straight | Suture: partial | Nil | ||
| 29 | 1 large | Curved | Suture | Nil | ||
| 30 | 1 large | N/A | N/A | N/A | ||
| 81 | 1 large | Articulated (curved) | Nil | Partial | ||
| 24 | N/A | N/A | N/A | N/A | ||
| 125 | 2 small | Straight | Suture | Nil | ||
| 20 | 1 large | Articulated | Suture: 2 (10) | Nil | ||
| 29 | 1 large | Curved | Suture | Nil | ||
| 35 mini-4ILC + 35 4ILC | 1 large | Straight | K wire: 6 (17.1) | Nil | ||
| 53 | 2 small | Straight | Suture | Nil | ||
| 30 | 1 large | Straight | Nil | Nil | ||
| 71 | 1 large | Straight (roticular) | Nil | Nil | ||
| 20 | 1 large | Curved | Nil | Nil | ||
| MILC incision and size (mm): Paraumbilical, subxiphoid, right subcostal, right flank | Learning curve | Operative time | EBL | Successful | Open conversion | Mortality |
| 4ILC: 10, 5, 5, 5 | N/A | S > M | N/A | 47 (94) | 0 | 0 |
| 4ILC: 10, 10, 5, 5 | N/A | S = M | N/A | 20 (100)2 | 0 | 0 |
| 3ILC: 10, 5, 5; 4ILC: 10, 5, 5, 5 | N/A | S > 3ILC = 4ILC | N/A | 27 (90) | 0 | 0 |
| 4ILC: 12, 12, 5, 5 | N/A | S > M | S = M | 43 (71.7) | 0 | 0 |
| 3ILC: 10, 10, 5 | 10 for op time | S > M | S = M | 44 (88) | 4 (8) | 0 |
| 3ILC: 10, 5, 5 | N/A | S = flexible S = M | N/A | 40 (100) | 0 | 0 |
| 4ILC: 10, 10, 10, 10 | N/A | S = M | N/A | 43 (100) | 03 | 0 |
| 4ILC: 12, 5, 5, 5 | 40 for op time | S > M | S = M | 44 (89.8) | 0 | 0 |
| 4ILC: 10, 5, 5, 5 | N/A | S > M | S = M | 39 (97.5) | 0 | 0 |
| 4ILC: 10, 5 (10), 5, 5 | N/A | S = M | N/A | 28 (100) | 0 | 0 |
| Mini-3ILC: 10+5, 2, 2 | N/A | S > Mini-3ILC | N/A | 28 (93.3) | 0 | 0 |
| 4ILC: 10 (12), 5 (10) (12), 5, 5 | N/A | S > M | S = M | 118 (99.2) | 0 | 0 |
| N/A | N/A | N/A | N/A | N/A | N/A | N/A |
| 4ILC: 10, 10, 5, 5 | 25 for op time | S = M | S = M | 121 (96.8) | 0 | 0 |
| 4ILC: 10, 10, 5, 5 | N/A | S > M | N/A | 18 (90) | 0 | 0 |
| 4ILC: 10, 5 (10), 5, 5 | 20 for method standardization | S = M | N/A | 28 (100) | 0 | 0 |
| Mini-4ILC: 10, 3, 3, 3; 4ILC: 10, 10, 5, 5 | N/A | S = Mini-4ILC > 4ILC | N/A | 34 (97.1) | 0 | 0 |
| 3ILC: 10, 10, 5 | N/A | S = M | S = M | 48 (98.0) | 0 | 0 |
| 4ILC: 10, 5, 5, 5 | Nil | S > M | N/A | 30 (100) | 0 | 0 |
| 3ILC (4ILC): 10, 11, 5 (10, 11, 5, 5) | N/A | S = M | N/A | 68 (98.6) | 0 | 0 |
| 4ILC: 10, 10, 5, 5 | N/A | S = M | N/A | 20 (100)2 | 0 | 0 |
| Overall complication | BDI | Incisional hernia | Pain | LOS | ||
| S: 4 (8) = M | 0 | S: 1 (2) = M | S < M | S = M | ||
| 0 | 0 | 0 | N/A | N/A | ||
| 0 | 0 | 0 | S < M (3ILC or 4ILC) | S = M (3ILC or 4ILC) | ||
| S: 2 (3.3) = M | S: 1 (1.7) →BL | S: 1 (1.7) = M | S = M | S = M | ||
| S: 2 (4) = M | 0 | 0 | S > M (POD 1) | S = M | ||
| S: 0 = flexible S: 1 (5) = M | 0 | 0 | S = flexible S = M | Flexible S < S = M | ||
| S: 1 (2.3) = M | 0 | 0 | S > M (POm 30) | S = M | ||
| S: 1 (2.04) = M | 0 | 0 | S = M | S = M | ||
| N/A | 0 | N/A | S = M | S = M | ||
| S: 3 (10.8) = M (wound complication) | 0 | 0 | S < M (POH 24) | N/A | ||
| 0 | 0 | 0 | S = Mini-3ILC | S = Mini-3ILC | ||
| S: 53 (45) = M | 0 | S: 10 (8.4) > M | S > M | N/A | ||
| N/A | N/A | N/A | N/A | N/A | ||
| S: 5 (4) = M | 0 | 0 | S < M (early to POW 1) | S = M | ||
| S: 1 (5) = M | 0 | 0 | S = M | N/A | ||
| S: 3 (10.8) = M (wound complication) | 0 | 0 | S < M (POH 24) | S: < 24 h = M | ||
| S: 8 (22.9) > Mini-4ILC: 0 = 4ILC | 0 | S: 1 (2.9) | S = Mini-4ILC = 4ILC | S = Mini-4ILC = 4ILC | ||
| S = M (port-site complication) | 0 | 0 | S < M (POH 8) | S = M | ||
| 0 | 0 | 0 | S = M | S = M | ||
| S: 3 (4.3) = M | 0 | S: 1 (1.4) | S < M (POH 12) | S > M | ||
| 0 | 0 | 0 | S < M | S = M | ||
| Cosmesis | Satisfaction | Cost | Follow-up | |||
| S = M | S = M | N/A | 6 mo | |||
| N/A | N/A | N/A | N/A | |||
| S = M (3ILC or 4ILC, late) | S = M (3ILC or 4ILC) | N/A | 12 mo | |||
| S > M | N/A | N/A | 12 mo | |||
| S > M | N/A | N/A | 24 mo | |||
| N/A | N/A | N/A | > 1 yr | |||
| N/A | N/A | N/A | 7 d | |||
| S = M | S = M | S > M | 16.4 mo | |||
| S > M (POW2) | N/A | S = M | 2-4 wk | |||
| N/A | N/A | N/A | N/A | |||
| S < Mini-3ILC | N/A | N/A | 1 mo | |||
| S > M | N/A | N/A | < 12 mo | |||
| S > M (POM 16-38) | N/A | N/A | Early: 6-12 wk; Late: 16-38 mo | |||
| S > M (POM 1,6) | N/A | N/A | 6 mo | |||
| N/A | N/A | N/A | 1 mo | |||
| N/A | N/A | N/A | 5.92 mo | |||
| S = Mini-4ILC > 4ILC (POM 6) | N/A | N/A | 12 mo | |||
| S > M (POM 2) | N/A | S = M | 2 mo | |||
| N/A | N/A | S = M | 6 wk | |||
| S > M | S > M | N/A | 7.3 mo | |||
| N/A | N/A | N/A | N/A |
1
The same populations examined with different end points;
2
One case with a procedure converted to 2ILC was excluded;
3
Two cases with open conversion were excluded. SILC or S: Single-incision laparoscopic cholecystectomy; flexible SILC or S: Single-incision laparoscopic cholecystectomy using a flexible endoscope; AC: Acute cholecystitis; N/A: Not available; MILC or M: Multi-incision laparoscopic cholecystectomy; GB: Gallbladder; K wire: Kirschner wire; IOC: Intraoperative cholangiography; 4ILC: Four-incision laparoscopic cholecystectomy; 3ILC: Three-incision laparoscopic cholecystectomy; EBL: Estimated blood loss; BDI: Bile duct injury; BL: Bile leak from cystic duct stump; POD: Postoperative day; POm: Postoperative minute; POH: Postoperative hour; POW: Postoperative week; LOS: Length of hospital stay; POM: Postoperative month; large fasciotomy: ≥ 20 mm; small fasciotomy: ≤ 10 mm.