Abstract

Aim: To compare 3 ports versus conventional 4 ports laparoscopic cholecystectomy.

Design of the Study: It was a randomized controlled trial.

Place and Duration of Study: This study was carried at the Department of Surgery, Sir Ganga Ram Hospital, Lahore over 6 months from March 2017 to September 2017.

Methods: The study involved 100 patients with symptomatic gallstone disease. These patients were randomly divided into two treatment groups; Group-A underwent conventional 4 ports laparoscopic cholecystectomy while Group-B underwent 3 ports laparoscopic cholecystectomy. Operating time, CBD injury, need for conversion, post-operative pain, length of hospital stay and wound infection were noted and compared between the groups. Written informed consent was taken from every patient.

Results: The mean age of the patients was 41.9±6.8 years having a female predominance with male to female ratio of 1:1.9. The experimental 3 ports laparoscopic cholecystectomy was superior to 4 ports laparoscopic cholecystectomy in terms of significantly lower mean VAS score for pain (2.44±0.61 vs. 4.52±1.07; p-value<0.0001) 24 hours after the surgery. However, there was no significant difference in terms of frequency of conversion to open cholecystectomy (4.0% vs. 2.0%; p-value=0.558), CBD injury (2.0% vs. 0.0%; p-value=0.315), and wound infection (6.0% vs. 8.0%; p-value=0.695).

Conclusion: In the present study, 3 ports laparoscopic cholecystectomy was associated with significantly lesser post-operative pain on visual analogue scale 24 hours after the surgery as compared to conventional 4 ports laparoscopic cholecystectomy without any compromise on safety of the procedure. This advantage of 3 ports LC was unaffected by patient’s age, gender, obesity and duration of disease.

Keywords: Laparoscopic Cholecystectomy, 3-Ports, 4-Ports