Risk factors for a prolonged operative time in a single‐incision laparoscopic cholecystectomy

Abstract Background A prolonged operative time is associated with adverse post‐operative outcomes in laparoscopic surgery. Although a single‐incision laparoscopic cholecystectomy (SILC) requires a longer operative time as compared with a conventional laparoscopic cholecystectomy, risk factors for a prolonged operative time in SILC remain unknown. Methods A total of 20 clinical variables were retrospectively reviewed to identify factors for a prolonged operative time (longer than 3 h) in a total of 220 consecutive patients undergoing SILC. Results The median operative time was 145 min (range, 55–435) and a prolonged operative time was required in 62 patients (28%). Independent factors that predict a prolonged operative time as identified through multivariate analysis were body mass index (BMI) ( P = 0.009), acute cholecystitis ( P < 0.001) and operator (resident or staff surgeon) ( P < 0.001). Furthermore, a prolonged operative time was significantly associated with an increased amount of intra‐operative blood loss ( P < 0.001) and a prolonged stay after surgery ( P < 0.001). Conclusions These findings suggest that a higher BMI, acute cholecystitis and a resident as an operator significantly increase the duration of SILC procedures.