A study of three-port versus four-port laparoscopic cholecystectomy

Harsha, HS; Gunjiganvi, Mallikarjun; Singh, Ch. Arunkumar; Moirangthem, G. S.

doi:10.4103/0972-4958.127395

Cited by 6 publications

(5 citation statements)

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“…As seen in many publications, the incidence of this complication varies between 16-33%. In Harsha HS et al's [24] study, in 2013, this complication's incidence in operations performed with three-port method was found to be less than the others, and also than the classic four-port method. [25] In our study, 11 gallbladder perforation incidences were determined in three-port method, and 6 gallbladder perforation incidences were determined in four-port method (p>0.05).…”

Section: Discussionmentioning

confidence: 89%

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Three-port versus standard four-port laparoscopic cholecystectomy: a clinical trial

Akay¹

2020

Laparosc Endosc Surg Sci

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Introduction: After the first laparoscopic cholecystectomy was performed in 1987, the 4-port operation technique became the standard worldwide. This study is a comparison of the intraoperative complications observed using 3-port and 4-port methods, and an examination of the reliability of the 3-port method. Materials and Methods: The files of 400 patients who underwent a laparoscopic cholecystectomy due to gallbladder disease between 2014 and 2019 were analyzed. The patients were divided into 2 groups according to the use of a 3-port or a 4-port method, and the intraoperative complications of the groups were compared. Results: A total of 400 patient files were reviewed and the only significant difference between the 2 groups among the parameters of age, gender, and weight was the female-male ratio. Of the 3-port cases, 13.5% were male, and 86.5% were female. Of the 4-port cases, 23.5% were male and 76.5% were female (p=0.010). A significant difference was not seen between the 2 groups with respect to the mean operation time (p=0.548) or operation success (p=0.253). The average hospitalization period was longer in the 3-port group (1.98 days vs 1.18 days, respectively; p<0.001). No significant difference was found in the number of intraoperative complications: gallbladder perforation (p=0.215), liver laver hemorrhage (p=0.481), entry of the gallstone into the abdomen (p=0.760), and choledoch injury (p=0.522). Conclusion: The success rate of a laparoscopic cholecystectomy was similar in the 3-port and 4-port groups. The mean length of hospitalization was longer in the 3-port group compared with the 4-port group. Analysis suggested that the greater number of intraoperative complications in the 3-port group had an effect on the hospitalization period. There were no instances of further complications developing after the 3-port procedure.

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Section: Discussionmentioning

confidence: 89%

“…[11] Harsha H.S. [24] and Gurusamy KS et al [25] demonstrated that the threeport technique increases the risk of biliary tract injury.…”

Section: Discussionmentioning

confidence: 99%

Three-port versus standard four-port laparoscopic cholecystectomy: a clinical trial

Akay¹

2020

Laparosc Endosc Surg Sci

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“…Harsha et al [14] showed that mean operative time for threeport LC was shorter. In our study, there was a statistically significant difference between the two groups in terms of operation time (p=0.001).…”

Section: Discussionmentioning

confidence: 99%

“…[1] In addition, the three-port technique caused less pain than the four-port technique, so less analgesics are required for pain control and reduce costs by reducing the hospital stay. [14] It also leads to better cosmetic results. [1] Therefore, in this study, we aimed to compare the oxidant effect of four and three-ports using MDA and AOPP.…”

Section: Discussionmentioning

confidence: 99%

Effects of different trocar numbers on oxidative stress in laparoscopic cholecystectomy

Tiryaki¹

2019

Laparosc Endosc Surg Sci

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Introduction: Increase in intra-abdominal pressure during pneumoperitoneum (Pp), and inflation-deflation, which cause splanchnic ischemia-reperfusion (I/R), are the reasons for oxidative stress in LS. However, not only Pp and I/R but also surgical trauma has an effect on oxidative stress. This study aims to discuss the number of trocar entry effects on oxidative stress as a surgical trauma in LS. Materials and Methods:Patients were divided into two groups; three-port cholecystectomy (group 1, n=20) and four-port cholecystectomy (group 2, n=20). All patients' venous blood samples were taken three times; preoperatively, postoperative 6 th and 24 th hours for study Malondialdehyde (MDA) and advanced oxidation protein products (AOPP) to evaluate oxidative stress. Results:There was no statistically significant difference between the two groups. However, a statically significant difference was observed in MDA levels between preoperative and PO six hours, and duration of operation (p=0.001). Conclusion:In our study, the findings showed that laparoscopic cholecystectomy (LC) can be performed safely with three or four trocars, and a similar oxidative response was observed in both groups. Surgical trauma that arises from trocar entry (3 or 4-trocar) did not change the oxidative stress response in our patients.

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“…Many surgeons have been reported that the forth port is not necessary and it is already accepted as a safe and effective procedure for gall bladder diseases. 8 In many institute conventional three-port LC is the primary option. 7 Recently some surgeons reported about a new modification in 3 port LC technique.…”

Section: Introductionmentioning

confidence: 99%

Three Port Laparoscopic Cholecystectomy by a Modified Technique

Khan¹,

Ansary

Talukdar

et al. 2022

J Shaheed Suhrawardy Med Coll

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Introduction:Since the introduction of laparoscopic cholecystectomy (LC) several modifications have been introduced to its procedure. Main aim of these modifications is to improve cosmesis & reduce pain. Several institutes are routinely performing conventional 3 ports laparoscopic. In modified 3 ports LC, the third port was moved from right hypochondrium to umbilicus, to conceal it in the umbilical scar, thereby giving the three port comfort to the surgeon and two port benefits to the patient. Methods: This observational study was conducted in the Department of Surgery of Shaheed Suhrawardy Medical College & Hospital from September 2015 to October 2016. After taking valid consent a total 45 patients were selected for modified 3 ports LC. Here we tried to see the safety and benefit of this modified technique by assessing operating time, intra-operative complications, open conversion rate, postoperative wound infection, post-operative hospital stay, pain score and satisfaction with cosmetic outcome. Results: 3 patients were excluded from study due to different reasons. So, among total 42 (N) patients 30 (71.4%) were female & 12 (28.6%) were male. Operative time was 58.48 ± 32.52 minutes (range 34 to 180 minutes). 2 patients required conversion to open surgery. Pain score was 2.07 ±1.71 and cosmetic score was 8.67 ± 1.99. Conclusion: Modified 3 port laparoscopic cholecystectomy can be performed safely with a higher cosmetic satisfaction in selected cases by expert surgeon. J Shaheed Suhrawardy Med Coll 2020; 12(2): 90-94

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A study of three-port versus four-port laparoscopic cholecystectomy

Cited by 6 publications

References 0 publications

Three-port versus standard four-port laparoscopic cholecystectomy: a clinical trial

Three-port versus standard four-port laparoscopic cholecystectomy: a clinical trial

Effects of different trocar numbers on oxidative stress in laparoscopic cholecystectomy

Three Port Laparoscopic Cholecystectomy by a Modified Technique

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