"ASSESSING THE EFFICACY AND SAFETY OF THREE PORT VS FOUR PORT TECHNIQUE IN LAPAROSCOPIC CHOLECYSTECTOMY"
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Keywords
Laparoscopic cholecystectomy; Three-port technique; Four-port technique; Gallstones; Minimally invasive surgery; Operative time
Abstract
Background: Laparoscopic cholecystectomy has evolved as the gold standard for the treatment of symptomatic cholelithiasis. Recent innovations seek to minimize invasiveness by reducing the number of ports. This study compares the outcomes of three-port and four-port laparoscopic cholecystectomy. Methods: This prospective comparative study was conducted at Santosh Medical College over 1.5 years, involving 124 patients undergoing elective laparoscopic cholecystectomy. Patients were randomly allocated to either the three-port or four-port group. Outcomes compared included operative time, intraoperative complications, postoperative pain, analgesic requirements, hospital stay, cosmesis, and conversion rates. Results: The three-port group showed significantly shorter mean operative time (65 vs. 104 min, p<0.001), lower analgesic requirements, and shorter hospital stay (mean 1.98 vs. 4.79 days, p<0.001). Both groups had similar complication rates and return-to-activity times. Scar cosmesis, assessed by POSAS, favored the three-port group. Conversion to open surgery occurred only in one patient in the three-port group. Conclusion: Three-port laparoscopic cholecystectomy is a safe and effective alternative to the conventional four-port technique, offering benefits in operative efficiency, reduced analgesic requirement, and improved cosmetic outcomes without compromising safety.
References
2. Reynolds W. The first laparoscopic cholecystectomy. J Soc Laparoendosc Surg. 2001;5(1):89–94.
3. Gollan J, Kalser S, Pitt H. National Institutes of Health (NIH) consensus development conference statement on gallstones and laparoscopic cholecystectomy. Am J Surg. 1993;165:390–6.
4. Lujan J, Parrilla P, Robles R, Marin P, Torralba J, Garcia-Ayllon J. Laparoscopic cholecystectomy vs open cholecystectomy in the treatment of acute cholecystitis. Arch Surg. 1998;133(2):173–5.
5. Bari SU, Wani RA, Wani NA, Zargar SA, Parray FQ, Malik AA. Three-port versus four-port laparoscopic cholecystectomy: a comparative study. Int J Res Med Sci. 2019;7(8):3054–9.
6. Kimura Y, Takada T, Kawarada Y, Nimura Y, Hirata K, Sekimoto M, et al. Definitions, pathophysiology and epidemiology of acute cholangitis and cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14:15–26.
7. Raza M, Venkata RM. Predicting difficulty in laparoscopic cholecystectomy preoperatively using a scoring system. Int Surg J. 2019;6(3):957–62.
8. Bansal A, Mahobia HS, Waghoikar G. A clinical study to determine predictive factors for difficult laparoscopic cholecystectomy. Int J Surg Sci. 2020;4(4):126–32.
9. Kumar M, Agrahari P, Rai A, Raj R, Gupta V, Yadav S. Comparative study of three-port versus four-port laparoscopic cholecystectomy. Int Surg J. 2022;9(1):223–6.
10. Singhal P, Gautam S, Siddiqui SA. Three-port versus four-port laparoscopic cholecystectomy: a prospective comparative study. Int Surg J. 2020;7(12):4124–8.
11. Ercan M, Tuncer AA, Ozkan Z, Ozkan OV, Yildiz MK, Bas G, et al. Predictive factors for conversion to open surgery in laparoscopic cholecystectomy. J Clin Med Res. 2011;3(1):30–4.
12. Krishnanand S, Tripathi R, Gupta V. Comparative study of three-port and four-port laparoscopic cholecystectomy. Int Surg J. 2017;4(1):297–300.
13. Nidoni R, Udachan TV, Sasnur P, Baloorkar R, Shinde SR, Narasangi B. Predicting difficult laparoscopic cholecystectomy based on clinicoradiological assessment. Indian J Surg. 2015;77(Suppl 2):S301–4.
14. Palanivelu C. Art of Laparoscopic Surgery: Textbook and Atlas. Vol. 1. 1st ed. New Delhi: Jaypee Brothers Medical Publishers; 2005. p. 412–5.
15. Vyas HG, Sonawane RS, Pujari BD, Narkhede RR, Rajguru JP, Nichat VS. A prospective study of preoperative evaluation of difficult laparoscopic cholecystectomy. Int J Med Res Rev. 2016;4(3):469–74.
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Jash Divyeshbhai Jagani
Post Graduate Student, Department of General Surgery, Santosh Medical College and Hospital. Ghaziabad
Shalabh Gupta
Professor and Head, Department of General Surgery, Santosh Medical College and Hospital. Ghaziabad
Jai Prakash
Assistant Professor, Department of General Surgery, Santosh Medical College and Hospital. Ghaziabad
Pavani Boddupalli
Post Graduate Student, Department of General Surgery, Santosh Medical College and Hospital. Ghaziabad
Yogendra Kumar
Professor, Department of General Surgery, Santosh Medical College and Hospital. Ghaziabad