Two Port and Two Suture Modified Laparoscopic Cholecystectomy Technique

Abstract

Aim:Laparoscopic cholecystectomy is the gold standard method for the treatment of gallstone disease. In this study, the two-port laparoscopic cholecystectomy technique was described.Materials and Methods:The inclusion criteria were having current or past biliary colic, risk of developing gallbladder cancer, porcelain gallbladder, gallbladder polyp larger than 5 mm, and asymptomatic large gallbladder stones (>20 mm). The exclusion criteria were determined as having a suspicious malignancy, an American Society of Anesthesiologists score of 4 or 5, diagnosis of choledocholithiasis, a history of endoscopic retrograde cholangiopancreatography, past intra-abdominal surgery, and a body mass index >33 kg/m2.Results:Two-port laparoscopic cholecystectomy was performed in 48 patients. Eleven patients (22.9%) were operated on with a preliminary diagnosis of cholecystitis and 37 patients (77.1%) with a prediagnosis of cholelithiasis. While 39 (81.2%) patients had multiple stones in the gallbladder, 9 (18.8%) had a single stone. The mean gallbladder wall thickness was 4.3±1.7 mm (range 2-10 mm), and the mean stone diameter was 14.0±10.2 mm (range 2-40 mm). The mean operation time in the whole group was 63.4 (range 42-86) minutes. Complications developed in 3 (6%) patients, including 3 subcutaneous infections.Conclusion:For standard four-port cholecystectomy, the two-port and two-suture assisted technique is a good alternative for selected cases. It can be applied successfully and is cosmetically effective.

Keywords

• two port laparoscopic cholecystectomy
• minimally invasive surgery
• methods
• equipment
• benign gallbladder disease