MTP5.13 Comparative outcomes between single incision versus multiple incision laparoscopic cholecystectomy: a systematic review and meta-analysis

Introduction The objective of this article is to compare the postoperative outcomes of single incision laparoscopic cholecystectomy (SILC) and multiple incision laparoscopic cholecystectomy (MILC). Methods Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized controlled trials comparing postoperative outcomes in patients undergoing SICL versus MILC. All data were analyzed using statistical software Review Manager 5.4, and the meta-analysis was performed with a random effect model analysis. Results A total of 55 randomized, control trials were included recruiting 6505 patients undergoing SILC versus MILC. In the random effect model analysis, SILC was associated with reduced pain postoperatively at 8-12 hours (Standard mean difference (SMD): -0.48; 95% confidence interval [CI]: [-0.91, -0.04], Z=2.16, P=0.03) and 1-14 days (SMD: -0.47 ; 95% CI [-0.82, -0.12], Z=2.66, P=0.008). SILC also significantly improved patient cosmesis scores 1-6 months postoperatively (SMD: 1.27; 95% CI [0.35, 2.18], Z=2.72, P=0.006) and 6 months onwards postoperatively (SMD: 0.58; 95% CI [0.25, 0.91], Z=3.43, P=0.0006). No statistical difference was seen in cost effectiveness, intraoperative, and postoperative complications. Conclusion SILC was found to decrease postoperative pain scores and offer cosmetic advantage while simultaneously demonstrating noninferiority in all other measured postoperative outcomes.