Single-port laparoscopic cholecystectomy with indocyanine green: A propensity score study.

Introduction: This study aims to compare the clinical efficacy of single-incision laparoscopic cholecystectomy (SILC) with indocyanine green (ICG) fluorescence imaging and traditional multi-port laparoscopic cholecystectomy (MPLC) in the treatment of benign gall bladder diseases.

Patients and methods: A retrospective analysis was performed on the clinical data of 345 patients who underwent laparoscopic cholecystectomy from June 2023 to June 2024. Forty-two patients underwent SILC, and 303 underwent MPLC. After propensity score matching, 37 matched pairs were identified. Parameters compared included critical view of safety (CVS) exposure rate, bile duct injury rate, operative time, blood loss, post-operative hospitalisation, costs, pain visual analogue scale (VAS) scores, Global Aesthetic Improvement Scale questionnaire scores, complication rates and the learning curve evaluated by cumulative sum analysis (CUSUM).

Results: No conversions or bile duct injuries occurred. The SILC group had shorter hospital stay (2.6 ± 0.7 days vs. 4.2 ± 0.9 days) and lower pain VAS scores at 48 h (1.1 ± 0.5 vs. 1.9 ± 0.4), but higher blood loss (19.4 ± 9.5 mL vs. 10.1 ± 4.2 mL) (P < 0.05). No significant differences were observed in CVS exposure, operative time, costs, pain scores at 24 h, complication rates or 30-day post-operative incisional satisfaction (P > 0.05). The CUSUM analysis showed the learning curve stabilised after 25 cases.

Conclusions: ICG-assisted SILC demonstrates comparable safety and cost-effectiveness to MPLC, without increasing perioperative risks. With appropriate patient selection, it may be a viable option for broader implementation in primary healthcare settings.