Background: Our objective was to compare hospital charges and both perioperative and mid-term quality of life between single- (SILC) and multi-incision (MILC) laparoscopic cholecystectomy in a randomized controlled trial. Methods: Patients with acute or chronic biliary disease were invited to participate. Pain scores, quality of life, and perioperative outcomes were measured. Patients were followed for 1 year postoperatively in the clinic with examination to document hernia formation. Results: One hundred subjects were randomized to SILC (n = 49) or MILC (n = 51). Demographics were similar for both groups except more women underwent SILC (86% vs 67%, P =.026). Operative time was greater for SILC (63.5 ± 21.0 vs 43.8 ± 24.2 minute, P <.0001). Five SILC patients required added ports. One substantial complication occurred in SILC. Pain, the use of analgesics, and duration of hospital stay were equal between groups; however, charges were greater in the SILC group ($17,602 ± $6,089 vs $13,342 ± $8,197, P <.0001). Both groups reported similar quality of life and cosmesis. At an average follow-up of SILC (16.4 ± 12.1 months) and MILC (16.2 ± 10.5 months), no novel umbilical hernias were identified. Conclusion: SILC results in longer operative time and greater hospital charges with similar pain and quality of life scores compared with a standard laparoscopic approach.
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