A study of three-port versus four-port laparoscopic cholecystectomy

Abstract

Objectives: The objective of this study was to investigate the technical feasibility, safety and benefit of three-port laparoscopic cholecystectomy (LC) over the conventional standard four-port LC as routine setup. Materials and Methods: A total of 50 patients willing to participate in the study with valid consent were allocated into two groups by computer generated chit system. The first group, three-port LC group consisted of 25 cases and the second group, the standard four-port LC group consisted of 25 cases were analyzed for the following outcome measures namely conversion rates, operating time, intra-operative complications, post-operative pain score, analgesic requirement and hospital stay. Results: Demographic data was comparable in both groups. Conversion rate was nil in both groups. The mean operating time was comparable in both groups. Post-operative pain was significantly less in three-port group (P < 0.008) and analgesic requirement (P < 0.001) when compared with the four-port group. Hospital stay was significantly less in three-port group compared with the four-port group (P < 0.004) owing to post-operative pain score. There was no statistical difference in the complications rate in both groups; gallbladder perforation (P = 0.691), bile leakage (P = 1.00) and bleeding from liver bed (P = 0.691). Conclusion: three-port LC is technically safe and feasible with less post-operative pain score, less analgesic requirement, less hospital stay with comparable operating time and complications when compared to four-port LC. Three-port is also associated with less scars and cosmetic superiority.