Effect of Gall Bladder Retrieval via Epigestric Vs Umbilical Port in Laparoscopic Cholectystectomy

Abstract

Background and Aim: The retrieval of the gallbladder is a key event in laparoscopic cholecystectomy and significantly contributes to postoperative infections and pain. The GB is extracted through an umbilical or epigastric port. The goal of this single-center study was to compare GB retrieval via epigastric versus umbilical port in terms of postoperative site pain and infections. Materials and Methods:In this single-center study, 60 Cholelithiasis patients under went laparoscopic cholectystectomy (LC) for symptomatic gallbladder disease during the period from November 2020 to April 2021 at surgery department of Gambat Institute of Medical Sciences, Gambat Sindh Pakistan. The patients were selected out of the operating room for GB retrieval via umbilical port (Group-I with n = 30) versus epigastric port (Group-II with n = 30) randomly.All 60 patients had routine blood tests such as CBC, SGOT, SGPT, PT, and urine examinations. Until their bowels recovered, all of the patients were kept nil by mouth and on parenteral fluids. They were closely monitored in the post-operative period, with special attention paid to recording the pulse rate, temperature, and level of pain on a 24-hour basis. Results:Chronic Cholecystitis patients chosen randomly from the cholecystectomy list to have their gallbladder delivered through an umbilical or epigastric port.Group I had median pain (IQR) of 5 (1.5), 4 (1), and 2 (1) when compared to group II's median pain (IQR) of 4 (1), 2 (1), and 1 (0.5) one day after the procedure (p-value=0.001), at the time of hospital discharge (p-value0.001), and one month post-surgery (p-value0.001).In group B, there was a clear regression in postoperative pain from the day of surgery until a month later (p-value0.001). Conclusion:According to our findings, umbilical ports are preferable to epigastric ports in terms of post-operative pain, but there is an increased port site infection and hernia risk. Keywords:Cholecystectomy, Umbilical port, Epigastric port, Gall bladder retrieval, Laparoscopic.