Comparison of efficacy between modified transumbilical single-port and conventional 3-port laparoscopic cholecystectomy using inflammatory factors and serum amylase: An observational study.

This study aims to compare the efficacy of modified transumbilical single-port and conventional 3-port laparoscopic minimally invasive cholecystectomy based on the levels of inflammatory factors and serum amylase. Ninety-one patients with benign gallbladder diseases admitted to our hospital from January 2023 to December 2024 were retrospectively analyzed. Patients were divided into group A (n = 45) and group B (n = 46) according to the surgical method. The group A accepted traditional laparoscopic cholecystectomy and the group B accepted modified transumbilical single-port laparoscopic cholecystectomy. The perioperative indicators, degree of pain, levels of inflammatory factors, liver function, serum amylase level, immune function, patients' satisfaction with aesthetic incision and incidence of complications were compared in both groups. Compared with group A, group B was associated with a longer operative time (95% confidence interval: -15.9 to -1.5; P = .018). Group B demonstrated significantly lower pain scores at both 12 hours (postoperative day [POD] 0.5) and 24 hours (POD 1) postoperatively (both P <.001), with multivariate analysis confirming these differences remained significant after adjustment for covariates (P <.001). While both groups showed postoperative elevations in inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), interleukin-8 (IL-8), IL-2, tumor necrosis factor-alpha (TNF-α)], liver enzymes [total bilirubin (TBIL), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT)], and serum amylase, Group B maintained significantly lower hs-CRP levels after adjustment (P = .018). Immunological assessment revealed better-preserved immunoglobulin levels [Immunoglobulin A (IgA), IgG, IgM] in Group B at POD 7 (all P <.001). Patients receiving the single-port technique reported higher cosmetic satisfaction (95% confidence interval: -0.88 to -0.45, P <.001) and experienced fewer complications (P <.05). No significant intergroup differences were observed in recovery milestones (first flatus, first defecation), hospital stay, or intraoperative blood loss (all P >.05). The modified transumbilical single-port laparoscopic cholecystectomy may reduce the degree of pain, reduce the inflammatory response, reduce serum amylase level, improve the liver function and immune function, promote patients' satisfaction with aesthetic incision and reduce the incidence of complications. However, the retrospective design limits causal inferences and requires validation by prospective studies.