Background: Present study was conducted to evaluate and compare the safety outcome and advantages of three-port and four-port LC.
Methods: This prospective study included 100 patients presenting with symptomatic gall stone disease or gall bladder polyp more than 1 cm at base. Patients with jaundice and choledocholithiasis were excluded. Patients were divided into two groups: A and B, who underwent three-port and four-port LC respectively. Results: The mean age of Group A patients was 46.4±8.53 Yrs and Group B was 45.24 ± 10.34. 63% of
the operated patients were females and 37% males. Adhesion was seen in 24.00% patients in Group A and 22.00% patients in Group B. In the three-port group, 45 cases were completed successfully without
any need for conversion. 4 patients were converted to four-port procedure and 1 patient was converted to open cholecystectomy. In the four-port group, 3 cases were converted to open cholecystectomy for
completion. The average operative time was slightly more in the three- port LC group as compared to the four-port group. It was 46.3 +11.2 minutes for threeport cholecystectomy, ranging from 25 to 75 minutes.
In the four-port cholecystectomy group, it was 42.4 ± 15.4 minutes, ranging from 20 to 100 minutes. Pain at 6 hours and 24 hours post-operatively was found to be less in the three-port group than the four-port group. The mean Visual Analog Score was 5.71 ± 0.84 and 6.60 ± 0.83 at 6 hours; and 2.80 ± 0.81 and 3.60 ± 0.80 at 24 hours in the three-port and four-port groups respectively. The average number of hours of hospital stay was slightly less in the three-port group (37.8 ± 10.8 hours) as compared to the four-port cholecystectomy group (39.2 ± 5.6 hours). Conclusions: Three-port procedure is safe and appears to be more cost effective than four-port LC.
Keywords: Three-port; Four port; LC.