Comparison of abdominal pain after cholecystectomy from umbilical and subxiphoid ports in patients referred to Afzalipour Medical Education Center, Kerman

Abstract

Introduction: A consistent concern of surgeons is postoperative pain, whose control both alleviates patient suffering and reduces surgical complications, resulting in a quicker discharge and lower costs. This study aimed to compare abdominal pain (epigastric and right-upper quadrant) and pain at umbilical and subxiphoid ports after laparoscopic cholecystectomy in elective candidates at Afzalipour Medical Education Center, Kerman, Iran. Methods: In this clinical trial, 76 candidates for elective laparoscopic cholecystectomy were assigned to one of two groups via a simple random allocation method. Gallbladders were removed from the subxiphoid port in the control group and the umbilical port in the case group. Postoperative pain was assessed using the Visual Analogue Scale (VAS), and the analgesic consumption was measured at 6 hours, 24 hours, and two weeks postoperatively. Data were analyzed by SPSS 16 software using independent t-test, chi-square, and repeated measures test. Results: The mean port site pain score in the control group at 6 hours after surgery was 6.6±2.2, and in the case group, 6.3±1.9, and this difference was not statistically significant (P=0.519). The mean port pain score in the control group at 24 hours after surgery was 5.5±1.6 and in the control group was 4.9±1.1, where the difference was statistically significant (P<0.01). The mean port site pain score in the control group two weeks after surgery was 0.6±4.1, while in the control group, it was 3.0±0.9, where the difference was statistically significant (P<0.01). Conclusion: The results of our study demonstrated for the first time that there was no significant difference between patients whose gallbladder was removed through the umbilical port and those whose gallbladder was removed through the subxiphoid port concerning abdominal pain (epigastric and RUQ). Nevertheless, the removal of the gallbladder from the umbilical port 24 hours and two weeks after surgery reduced the patient’s port pain. This finding was evidenced descriptively by the VAS and quantitatively by the decline in analgesic prescriptions. Moreover, abdominal pain (epigastric and RUQ) was lower in patients with shorter operations.