الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic gallstone disease. The procedure is usually performed through four ports. A reduction in the number of ports has been suggested as a modification of standard technique with aim of reducing postoperative pain and improving cosmoses.
The aim of the present study was to compare between the single port laparoscopic cholecystectomy using SILSTM port and the single incision multiport laparoscopic (SIMPLE) cholecystectomy using regular ports placed through one incision as regards feasibility, safety, postoperative pain, complications and patient satisfaction.
In the present study 178 patients were assessed for eligibility, the inclusion criteria were fulfilled in 100 patients. They were divided randomly into two equal groups using the closed envelope technique; the single port laparoscopic cholecystectomy group (SPLC group=50 patients) and the Single incision multiport laparoendoscopic cholecystectomy group (SIMPLE group= 50 patients). There was no statistically significant difference between both study groups as regards the demographic data, the incidence of associated co-morbidities and the incidence of patients who had prior abdominal surgery.
In the present study, SPLC was attempted in 50 patients and was successfully completed through a single incision in 49 patients (98%). One patient was excluded from further analysis due to addition of an extra trocar. On the other hand, SIMPLE cholecystectomy was successfully completed in 48 patients (96%). Two patients were excluded from further analysis due to the addition of an extra trocar. The operative time in SPLC was statistically significantly longer than that in the SIMPLE group (mean: 80 Vs 61 minutes respectively; p<0.001). There was no statistically significant difference between both groups as regards the incidence of dissection induced gall bladder perforation and bile/stone spillage encountered. However, the incidence of needle-induced gallbladder perforation with bile spillage was statistically significantly higher in the SIMPLE group. In the SPLC group the classical critical view of safety with its three components could be achieved in 22 patients (44.9%), while in the SIMPLE group it could be achieved in 24 patients (50.0%) with the difference being statistically insignificant (p=0.571).