THREE PORT VERSUS FOUR PORT LAPAROSCOPIC CHOLECYSTECTOMY : A COMPARATIVE STUDY

Dr. Arun Kumar, Dr. Deepak Kumari, Dr. Prashant Gupta, Dr. Jugendra Pal Singh Shakya

Abstract


Aims & Objectives: To compare three port- laparoscopic cholecystectomy (3 LC) with four port- laparoscopic
cholecystectomy in term of safety, efcacy, post-op pain, hospital stay and complication rates.
Material & Methods: The present study was conducted in the department of Surgery, S.N. Medical College, Agra (U.P.). Total 104 adult
patients of cholelithiasis with chronic cholecystitis were included in the study. These 104 patients were randomly divided into two group (I & II)
consisting of 52 patients in each group. Study was conducted for a period of 1 year from Jan. 2017 to Jan. 2018.
Group-I: performed 3 port LC (3 port- laparoscopic cholecystectomy)
Group-II: performed 4 port LC (4 port- laparoscopic cholecystectomy).
The present study is being conducted to compare the various merits and demerits of 3 port LC and 4 port LC performed by same surgical team in
the same scenario in our setup in our medical college.
Results: Statistically signicant different was found between the two group in term of visual analogue score for pain at 6 and 24 hr, analgesic
requirement, duration of hospital stay and back to work and cosmetic outcome all being less in the three port LC group. Result of other variable
were comparable in the two groups.
Conclusion: Three port laparoscopic cholecystectomy resulted in less port site pain and better cosmetic outcome require fewer analgesic, fewer
surgical scar and without increase in complication with shorter duration of hospital stay.


Keywords


Laparoscopic Cholecystectomy, Cholelithiasis, Chronic Cholecystitis, 3 Port, 4 Port

Full Text:

PDF

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.

Soper NJ, Brunt LM, Kerbl K. Laparoscopic General Surgery. N Engl J Med. 1994;330(6):409-19.

Soper NJ, Stockmann PT, Dunnegan DL. Laparoscopic cholecystectomy. The new 'gold standard'? Arch Surg. 1992 Aug;127(8):917-21.

Mouret P. From the first laparoscopic cholecystectomy to frontiers of laparoscopic surgery; the future perspective. Dig Surg. 1991;8:124-5.

Khan SA, Kalra D, Tanwar P, Kumar N, Singh J, Meena V, Gupta S, Bharti D. Three ports versus four port (standard) laparoscopic cholecystectomy – comparative study of 60 cases of cholelithiasis. IOSR J Dent Med Sci 2016;15:138-141.

Saccomani G, Arezzo A, Percivale A, Baldo S, Pellicci R. Laparoscopic cholecystectomy can be performed safely with only three ports in the majority of cases. ChirItal 2009 Sep-Dec;61(5-6): 613-616.

Moreira-Pinto J, Lima E, Correia-Pinto J, Rolanda C. Natural orifice transluminal endoscopy surgery: a review. World J Gastroenterol 2011 Sep;17(33):3795-3801.

Helme S, Samdani T, Sinha P. Complications of spilled gallstones following laparoscopic cholecystectomy: a case report and literature overview. J Med Case Rep 2009 Jul;3:8626.

Lazaro C, Caseras X, Torrubia R, Banos JE. Measurement of psot-operative pain: analysis of the sensitivity of various self-evaluation isntruments. Rv. EspAnestesiolReanim 2003; 50(5): 230-6.

Harsha HS, Gunjiganvi M, Singh C, Moirangthem GS. A study of three-port versus four-port laparoscopic cholecystectomy. J Med Soc 2013 Sep;27(3):208-211.

Gurusamy KS, Samraj K, Ramamoorthy R, Farouk M, Fusai G, Davidson BR. Miniport versus standard ports for laparoscopic cholecystectomy. Cochrane Database Syst Rev 2010 Mar:CD006804.

Zaman M, Singal S, Singal R, et al. Comparison of open and closed entry techniques for creation of pneumoperitoneum in laparoscopic surgery in terms of time consumption,entryrelated complications and failure of techgnique. World J Laparos Sur 2015 Sep-Dec;8(3):69-71.

Husain A, Pathak S, Firdaus H. Assessment of operative predictors for difficulty in lapro¬scopic cholecystectomy. International Journal of Contemporary Medical Research 2016;3(4):1232-1234.

Riki S, Pradeep G, Muzzafar Z, Mishra RK. Comparison of Three-port vs four port laparoscopic cholecystectomy in a medical college in the periphery. World Journal of Laparoscopic Surgey, 2017, 10(1): 12-16.

Peeyush Kumar*, Anil K. S. Rana. Three-port versus four-port laparoscopic cholecystectomy: a comparative study at a tertiary care centre in North India. Int Surg J. 2018 Feb;5(2):426-432.


Refbacks

  • There are currently no refbacks.