Comparative Study of Three Port Versus Four Port Laparoscopic Cholecystectomy for Acute Calculus Cholecystitis

Abstract

Objective: To compare laparoscopic cholecystectomy These 3 port versus 4Port terms of  Post time taken for operation, pain score following operation, stay, and frequency of complications after surgery.

Study Design: Randomized controlled trial.

Place and Duration of Study: This study was conducted at the Department of General Surgery, Central Park Teaching Hospital, and Lahore from 1^st July 2018 to 31^st March 2019.

Materials and Methods: One hundred and twenty two diagnosed cases of acute calculous cholecystitis were included and divided into two equal groups of 61 patients each. Patients in group A underwent laparoscopic cholecystectomy by using 3 ports while patients in B Group underwent laparoscopic cholecystectomy by using 4 ports. Both the groups were analyzed in terms of mean operative time, postoperative pain according to visual analogue scale, mean hospital stay and frequency of post-operative complications including rate of conversion to open surgery, port site infection, injury to CBD and bile leak.

Results: The operative time was of 37.13±8.07 minutes in Group A while it was 43.87±7.16 minutes in B Group (p=0.001).The difference between both the groups in regard of mean pain score according to VAS at twelve and twenty four hours after surgery was statistically significant (p˂0.05). There was no sufficiently great difference between both the groups in terms of stay in the hospital (p=0.260) and frequency of converted to open surgery (0.154), injury to bile duct (p=0.315), wound infection (p=0.559) and bile leak (p=0.433).

Conclusion: Three port laparoscopic cholecystectomy is better than the standard 04 port lap cholecystectomy in terms of less operative time and pain following surgery with a comparable safety profile.