More Bile Duct Injuries With Single-Incision Laparoscopic Cholecystectomy

Medscape recently published an interesting health article. It is a reproduction of a report published by Reuters Health.

This article basically highlighted the findings of a recent publication in the June edition of the Annals of Surgery – a high impact surgical journal. The paper was titled “Single incision laparoscopic cholecystectomy is associated with a higher bile duct injury rate: a review and a word of caution” (Ann Surg 2012 Jul; 256:1-6)

Single-incision laparoscopic surgery is one of the new fab in minimally invasive surgery. It is also called “scarless” surgery or “single port surgery”. The concept is to make a larger wound right in the umbilicus, one large enough to allow the insertion of 2 or more instruments to perform the operation. Because the cut is made in the umbilicus, when the wound heals, it will be hidden within the belly-button, and hence appears as “scarless”. Because of this promise of superior cosmesis, and other touted benefits like less pain, faster recovery and so on, single-incision operations have become more prevalent. One of the first surgical procedures that adopted this technique is the removal of the gallbladder (cholecystectomy).

The main observation made by this review of 45 published reports, covering the surgical outcomes of 2626 patients was that single-incision laparoscopic cholecystectomy was associated with a higher bile duct injury rate, when compared to the conventional 4-port laparoscopic cholecystectomy. Bile duct injury is one of the most devastating complications of this surgery. Sometimes, surgical repair is required if the injury is severe. A cut bile duct during laparoscopic cholecystectomy often results in litigation.

Besides a higher incidence of bile duct injury, other important findings are:

  • potentially more long-term wound complications
  • post-operative pain may be similar or even more than conventional laparoscopic cholecystectomy
  • the cosmetic benefits may be minimal

The conclusion of the study?

At Nexus Surgical, we are very careful in selecting our patients who request for single-incision laparoscopic surgery. We will also ensure that these patients are aware of the risks and benefits.

If cosmesis is the main motivation why patients choose single-incision laparoscopic surgery, we will offer them needle-scopic or minilaparoscopic surgery as an alternative to consider. This technique preserves the safety of conventional laparoscopic cholecystectomy while reducing the scars, by using miniaturized instruments.

Do contact us should you require any further clarification.

Recent Articles

The Red Streaks on Your Legs

Have you noticed? Those fine purplish veins under the skin which appear like a spiderweb or tree branches at the

Categories

Share on facebook
Facebook
Share on whatsapp
WhatsApp
Share on linkedin
LinkedIn
Share on email
Email

Related Articles

Disclaimer

Nexus Surgical Associates makes no representation and assumes no responsibility for the information, contained on or available through this website without consultation with our doctors. The information provided on this website is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only. If you have concerns about your health, you should seek advice from a doctor or if you require urgent care you should go to the A&E.

Translate »