Postoperative complications following single-incision laparoscopic cholecystectomy: A retrospective analysis in 360 consecutive patients

Background: Single-incision laparoscopic cholecystectomy (SILC) is being increasingly performed based on recent evidence showing its cosmetic advantages. However, there is limited information on outcome data for SILC with respect to postoperative complications. Methods: We retrospectively reviewed a consecutive series of 360 patients undergoing SILC to evaluate the rate, features, and risk factors of postoperative complications. Results: During a median follow-up period of 671 days, 17 patients (4.7 %) developed postoperative complications, including bile duct injuries, intraabdominal abscess, wound infection, incisional hernia, paralytic ileus, and pneumonia. Reoperation was required in five patients (1.4 %). Overall inpatient mortality occurred in one patient (0.3 %) who developed aspiration pneumonia. In multivariate stepwise regression analyses, poor physical status (American Society of Anesthesiologists score of ≥3) and preoperative diagnosis of acute cholecystitis were identified as significant risk factors for the development of postoperative complications (P = 0.0009 and P = 0.04, respectively). Conclusions: These findings suggest that SILC is a relatively safe procedure with an acceptable postoperative complication rate but requires careful attention especially in patients with poor physical status and/or acute cholecystitis.