International Surgery Journal | June 2019 | Vol 6 | Issue 6 Page 1
International Surgery Journal
Gupta V et al. Int Surg J. 2019 Jun;6(6):xxx-xxx
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Original Research Article
Safety and feasibility of three port procedure in laparoscopic
cholecystectomy
Vipin Gupta, Shailendra Pal Singh, Somendra Pal Singh, Anil Kumar Keshari*,
Anil Kumar Erry, Poonam Gupta, Vikram Singh, Mayank Singh
INTRODUCTION
Gallstones are significant health problem worldwide,
affecting 10% to 15% of adult population.
1
They are
asymptomatic in majority of the cases. Approximately 1-
2% of asymptomatic patients will develop symptoms per
year requiring surgery, making cholecystectomy one of
the most common operations performed by surgeons.
Laparoscopic cholecystectomy is one of the most
commonly performed surgery in practice.
2
Prof. Dr. Erich
Mühe of Böblingen, Germany, performed the first
laparoscopic cholecystectomy on September 12, 1985.
Today laparoscopic cholecystectomy is the gold standard
procedure in gallstone diseases.
3-5
Standard laparoscopic
cholecystectomy is done by using 4 ports.
With increasing surgeon experience, laparoscopic
cholecystectomy has undergone many refinements
including reduction in port number and size.
6-9
The fourth
port is used to retract the liver for better exposure of
ABSTRACT
Background: Laparoscopic cholecystectomy is widely accepted gold standard technique for management of
cholelithiasis and has undergone many refinements including decrease in size and number of ports. Many researchers
have claimed that three-port laparoscopic cholecystectomy is safe and feasible method for management of
cholelithiasis but still it is not performed widely by the surgeons. Objective of our study was to assess the safety and
feasibility of three-port laparoscopic cholecystectomy by comparing the various defined parameters with the standard
four-port laparoscopic cholecystectomy.
Methods: The study included 100 patients and was divided equally in 2 groups. Patients in Group A underwent
laparoscopic cholecystectomy by three-port technique and in Group B were operated by four-port technique. Patients
in both the groups were compared in terms of operative time, intra-operative complications, post-operative pain, post-
operative complications and cosmesis outcome.
Results: The mean operative time was similar in both groups. Intra-op and post-op complications were also similar. 3
patients in Group A needed fourth port and 1 patient in both group required conversion to open cholecystectomy.
Mean pain score and requirement of parentral analgesia was found to be lower in Group A. Duration of hospital was
similar in both the groups. Patients in group A had slightly better cosmetic outcome.
Conclusions: Three-port laparoscopic cholecystectomy is a minimally invasive, safe and feasible technique and is not
difficult to master than other advanced techniques. In experienced hands, laparoscopy cholecystectomy can be
initially started with three-ports and can be converted to four-port if rarely necessary.
Keywords: Laparoscopic cholecystectomy, Cholelithiasis, Three port cholecystectomy
Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
Received: 08 April 2019
Revised: 20 April 2019
Accepted: 24 April 2019
*Correspondence:
Dr. Anil Kumar Keshari,
E-mail: akanilgoldi21@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/2349-2902.isj20192063