Three-port versus four-port laparoscopic cholecystectomy: A Randomized Controlled Trial

Abstract

Laparoscopic cholecystectomy (LC) is one of the most common surgery performed and is traditionallyperformed using four ports. With the aim of improving patient’s comfort, port numbers have beenreduced to single port. But feasibility and the extra expense that comes with single and doubleport LC has made them less attractive. Three port LC can be a safe alternative to four port LC, andvarious research has shown its safety. This study compares the three port LC with the traditionalfour port LC with the objective of assessing feasibility and benefit of the decreased port number.
We evaluated 217 patients who were randomly allocated for three port and four port LC. Both thegroups were compared for operative time, assessment of postoperative pain, days of hospital stay
and postoperative recovery time after discharge. The parameters were compared using StatisticalPackage for the Social Sciences (SPSS) version 16. Among 217 patients, 123 underwent three port LCand 94 underwent four port LC. The larger number were females (79.7%), and with comparable agegroup of patients. Rate of conversion to open cholecystectomy, postoperative pain scale, analgesicrequirement, average hospital stay and port site infection rates were comparable in both groups ofpatients. The average time taken for operation was less in three port LC than the four port LC butthis was not statistically significant. There is no significant difference between 3 port and 4 port LCin terms of time required for the surgery, conversion rate, complication and duration of hospital stay

Keywords : Four-port laparoscopiccholecystectomy, laparoscopiccholecystectomy, three-portlaparoscopic cholecystectomy