Three-port Versus Four-port Laparoscopic Cholecystectomy- An Interventional Prospective Study in Public Sector Hospitals

Abstract

Introduction: Cholelithiasis is a common ailment and affects about 10% of general population. Currently, the vast majority of operations for cholelithiasis are performed using laparoscopic techniques. Aim: To compare the three-port laparoscopic cholecystectomy with conventional four-port laparoscopic cholecystectomy. Materials and Methods: A prospective interventional study was conducted on 180 cases admitted to the hospitals attached to BMCRI, Bengaluru, from November 2018 to November 2020. The clinical profile of each patient was noted. The cases were confirmed by ultrasonography and they were randomised into two groups. One group underwent three-port laparoscopic cholecystectomy and the other group underwent four-port laparoscopic cholecystectomy. Intraoperative complications, conversion rates, postoperative pain, postoperative complications and duration of stay in the hospital were compared. Statistical data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and data was compared using Chi-square test. Results: Most of the participants were from 31-40 years (45.6%, 44.4%) in both the groups, more common in females. The mean duration of surgery in three-port and four-port group was 30.43±15.964 and 36.81±15.592 minutes, respectively. Out of 90 (100%), 56 (62.2%) in three-port group had Visual Analogue Scale (VAS) score 2 and 66 (73.3%) in four-port group had VAS score 3 (χ2=71.34; p=0.001). Conversion rates to open cholecystectomy were almost similar in both the groups. Hospital stay was also similar in both groups. Conclusion: A three-port laparoscopic cholecystectomy had lesser operating time and lesser analgesics requirement with similar intra and postoperative complication when compared to four-port laparoscopic cholecystectomy.

Keywords

• cholelithiasis
• chronic calculus cholecystitis
• gall bladder