Abstract
Background: Several studies have shown that 3-port laparoscopic cholecystectomy is technically feasible and has better outcome over four port LC. A comparative study was conducted with the aim to evaluate and compare the benefits of three-port over four-port laparoscopic cholecystectomy.
Methodology: The study was conducted in a Teaching hospital in a sub-urban area of Pune city, Maharashtra. This study was conducted among 80 patients who underwent laparoscopic cholecystectomy from January 2017 to February 2019. Post-operative Patients were assessed for days of hospital stay, visual analogue scale (VAS) pain score at 6 hrs and 24 hrs and time taken for return to routine activity.
Results: The VAS pain score at 6 hrs and 24 hrs was less among the three post LC cases as compared to four port LC cases which was statistically significant. (p=0.005). Duration of stay in hospital and return to routine activity was also significantly longer among four port LC cases.
Conclusion: Three-port LC technique is feasible and has better clinical outcomes, and the procedure has considerable advantages over four-port LC in relation.
Keywords: Three port Laparoscopic Cholecystectomy, Four port Laparoscopic Cholecystectomy, Visual analogue scale, Duration of stay in Hospital, Operative time etc.
References
- Shahedi WH. The biliary system through the ages. Int Surg. 1979;64(6):63-78.
- Gadacz TR. US experience with laparoscopic cholecystectomy. Am J Surg. 1993;165(4):450-4.
- Shea JA, Berlin JA. Indications and outcome of cholecystectomy: A comparison of pre and post-laparoscopic era. Ann Surg. 1998;227(3):343-50.
- Nahrwold DL. Biliary System. In: Sabiston DS, Lyerldy HK, eds. Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 15th Ed. WB Saunders Company, USA; 1997:1117-1148.
- Hunter JG, Oddsdottir M. Gallbladder and the extrahepatic biliary system. In: Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Pollock RE, eds. Schwartz’s Principles of Surgery. 8th Ed. Mc Graw Hill, New York; 2005:1187-1218.
- Dubois F, Icard P, Berthelot G, Levard H. Coelioscopic cholecystectomy: premilary report of 36 cases. Ann Surg. 1990; 211:60–62.
- Litynski GS. Profiles in laparoscopy: Mouret, Dubois, and Perissat: the laparoscopic breakthrough in Europe (1987–1988). JSLS. 1999;3(2):163–167.
- Trichak S. Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc. 2003;17(9):1434 –1436.
- Slim K, Pezet D, Stencl J Jr., et al. Laparoscopic cholecystectomy: an original three-trocar technique. World J Surg. 1995; 19(3):394 –397.
- Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J. Pain after micro laparoscopic cholecystectomy. A randomized double blind controlled study. SurgEndosc. 2000;14(4):340 –344.
- Kumar M, Agarwal C S, Gupta R K. Three-Port Versus Standard Four-Port Laparoscopic Cholecystectomy: a Randomized-Controlled Clinical Trial in a Community-Based Teaching Hospital in Eastern Nepal, Journal of the Society of Laparoendoscopic Surgeons (2007)11: 358–362
- Harsha HS, Gunjiganvi M, Singh C, Moirangthem GS. A study of three-port versus four-port laparoscopic cholecyst-ectomy. J Med Soc2013;27:208-11.
- Dhafir Al-Azawi, Nariman Houssein, Abu Bakir Rayis,Donal McMahon and Dermot J Hehir Three-port versus four-port laparoscopic cholecystectomy in acuteand chronic cholecystitis. BMC Surgery 2007, 7:8Accessed on 25.05.2019 from http://www.biomedcentral.com/1471-2482/7/8/prepub
- Kumar P, Rana AKS. Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India. IntSurg J 2018;5:426-32.
Corresponding Author
Dr Harshal Tambe
Gulmohar Bunglow, in front of Vedant Residency, Sus- Nande Road, Sus, Pune 411021
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.135
