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.

1. Shahedi WH. The biliary system through the ages. Int Surg. 1979;64(6):63-78.
2. Gadacz TR. US experience with laparoscopic cholecystectomy. Am J Surg. 1993;165(4):450-4.
3. Shea JA, Berlin JA. Indications and outcome of cholecystectomy: A comparison of pre and post-laparoscopic era. Ann Surg. 1998;227(3):343-50.
4. 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.
5. 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.
6. Dubois F, Icard P, Berthelot G, Levard H. Coelioscopic cholecystectomy: premilary report of 36 cases. Ann Surg. 1990; 211:60–62.
7. Litynski GS. Profiles in laparoscopy: Mouret, Dubois, and Perissat: the laparoscopic breakthrough in Europe (1987–1988). JSLS. 1999;3(2):163–167.
8. Trichak S. Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc. 2003;17(9):1434 –1436.
9. Slim K, Pezet D, Stencl J Jr., et al. Laparoscopic cholecystectomy: an original three-trocar technique. World J Surg. 1995; 19(3):394 –397.
10. 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.
11. 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
12. 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.
13. 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
14. 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.

Dr Harshal Tambe

Gulmohar Bunglow, in front of Vedant Residency, Sus- Nande Road, Sus, Pune 411021