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Background Laparoscopic cholecystectomy (LC) is now considered the gold standard for the treatment of symptomatic gallstone disease. Traditionally, it was performed with a four-port approach. Recently, attempts have been done to improve the established technique of LC aiming to minimize the invasiveness of this procedure by reducing the number and size of the surgical ports and instruments. Navarra and colleagues described the first single-incision laparoscopic surgery in 1997. It was performed using multiple ports through a single incision with the removal of the gallbladder through a single periumbilical skin incision. Patients and methods This prospective study was carried out on 40 patients with uncomplicated chronic calcular cholecystitis categorized into two equal groups. Group A patients underwent single-incision LC, whereas conventional LC was done in group B patients in the Gastrointestinal and Laparoscopic Surgery Unit, General Surgery Department, Tanta University Hospitals, during the study period (12 months, from November 2019 to November 2020 on 40 patients). Results There was no statistically significant difference between both groups regarding patient characteristics, and preoperative medical or surgical history. The operative time was significantly longer in group A patients with a mean 85.8 ± 25.3 min compared with group B in which the mean was 71 ± 2.6 min. The difference between both groups regarding postoperative pain, analgesia intake, and hospital stay was insignificant. Cosmetic satisfaction was significantly better in group A compared with group B. Conclusion Single-incision laparoscopic cholecystectomy is a safe, feasible but challenging procedure that needs experienced hands in handling the instruments in lack of triangulation. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to compare efficacy and complications between fundus-down and conventional laparoscopic cholecystectomy (LC) in treating contracted gallbladders with gallstones. Methods: Between January 1999 and May 2008, 64 patients with contracted gallbladders and gallstones were included in the study. Main outcome measures included conversion rate, complication rate, bile duct injury rate operation time, and postoperative stay. Results: The average postoperative hospital stay for fundus-down technique was 5 ± 3 days, and 7 ± 3 days for conventional technique ( P = 0.003). The conversion rate and complication rate were 0% (0/33) and 3.00% (1/33) for fundus-down technique, and 32.3% (10/31) and 22.6% (7/31) for conventional technique ( P = 0.0009 and 0.02, respectively). In subgroup analysis, fundus-down LC seemed to lower the bile duct injury rate from 2/31 (6.5%) to 0/33 (0%) compared with 6/1,468 (0.4%) ( P = 0.01 between 6.5% and 0.4% vs. P = 1.00 between 0% and 0.4%). Conclusions: It appears that fundus-down laparoscopic cholecystectomy is associated with lower conversion and complication rates and shorter postoperative hospital stay as compared with conventional laparoscopic cholecystectomy when used to treat patients with contracted gallbladders and gallstones. [ABSTRACT FROM AUTHOR]