Three-port versus four-port laparoscopic cholecystectomy

Abstract

Background/Aims: Since the first successful laparoscopic cholecystectomy with the establishment of pneumoperitoneum in France by Mouret in 1987, it has become the golden standard for cholecystectomy. Generally techniques with four trocars have been used with surgeons but some of them prefer 3-trocar techniques. Our aim is to compare the clinical outcomes of three- and four-port techniques prospectively. Methodology: Between 1998 and 2003, one hundred and forty-six consecutive patients who underwent elective laparoscopic cholecystectomy for cholelithiasis in the Medical Faculty of Suleyman Demirel University were randomized to receive either the three-port or the four-port technique. Operative time, (time from the beginning of the insufflation up to the closure of the skin), success rate, visual analogue pain score, analgesia requirements, postoperative hospital stay were compared. Results: No differences between the two groups could be found. Conclusions: Three-port technique is safe, effective, and economic but does not reduce the overall pain score and analgesia requirement. © H.G.E. Update Medical Publishing S.A.