TY - JOUR AU - Thowprasert, Weerayut AU - Orrapin, Saritphat PY - 2021/10/01 Y2 - 2024/03/29 TI - The Predictive Factors Associated with Longer Operative Time in Single-Incision Laparoscopic Cholecystectomy JF - Siriraj Medical Journal JA - Siriraj Med J VL - 73 IS - 10 SE - Original Article DO - 10.33192/Smj.2021.86 UR - https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/254006 SP - 672-679 AB - <p>Objective: The difficult laparoscopic cholecystectomy (LC) is defined as the presence of one of the following<br>conditions including prolonged operative time, conversion to open cholecystectomy or significant blood loss. At<br>present, there is no evidence of predictive factors related to longer operative time in single-incision laparoscopic<br>cholecystectomy (SILC). The aim of this study is to determine predictive factors associated with longer operative<br>time in SILC procedure.<br>Materials and Methods: A retrospective study was conducted of patients with benign gallbladder disease who<br>underwent SILC in Thammasat University Hospital between October 2014 and December 2020. Patients’ records<br>were reviewed. Primary outcomes were preoperative predictive factors associated with DSLC. Secondary outcomes<br>were perioperative and 3-month postoperative adverse outcomes.<br>Results: 592 SILC procedures were categorized as 80 DSLC and 512 non-difficult SILC (NDSLC). The median<br>(interquartile range) of operative time in all SILC procedure is 48 (38, 62) minutes. The threshold of operative time<br>of difficult SILC was 72 minutes. The multivariate analysis indicated 5 significant predictive factors. Obesity (body<br>mass index &gt; 25 kg/m2)) and abdominal pain reflected the difficulty of SILC procedures (p = 0.041 and p = 0.009).<br>Calcified gallbladder showed the highest RR of 14.08 (p = 0.011). Contracted gallbladder and chronic cholecystitis<br>were also predictive factors with RR of 13.79 and 3.64, respectively (p &lt; 0.001 and p = 0.007).<br>Conclusion: Obesity, abdominal pain, chronic cholecystitis, contracted gallbladder and calcified gallbladder were<br>preoperative predictive factors. Surgeons should perform the SILC procedure carefully when predictive factors are<br>identified.</p> ER -