A One Year Randomized Control Study to Compare the Outcomes of Two Incisions Three Ports and Four Ports Laparoscopic Cholecystectomy at KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi

Abstract

Laparoscopic cholecystectomy has been accepted as the gold standard procedure for symptomatic gall bladder disease with the benefits of short length of hospital stay, immediate regaining of physical activity, less post-operative pain, morbidity and mortality, and good cosmetic outcomes. Standard laparoscopic cholecystectomy is done by using four trocars. With increasing surgeon experience, laparoscopic cholecystectomy has undergone many refinements including reduction in port size and number to reduce the post-operative pain and improve cosmetic outcome. Three port, two port and even single incision laparoscopic cholecystectomy (SILC) has emerged. The present study was undertaken to establish the efficacy and safety of two incisions three ports laparocopic cholecystectomy as compared to standard four port laparoscopic cholecystectomy. METHODOLOGY This one year randomized control study was conducted in the department of general surgery of K.L.E.S Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2017 to December 2017. A total of 61 patients were divided into two groups, group A (two incision three ports laparoscopic cholecystectomy) and group B (standard four port laparoscopic cholecystectomy). RESULTS There was significantly lesser post-operative pain at both 6 hours and 24 hours with a better cosmetic satisfaction in the two incisions three ports laparoscopic cholecystectomy group with no significant difference in operating time. CONCLUSION The two incisions three ports laparoscopic cholecystectomy can be performed as a feasible and safe procedure like the standard four port procedure. The outcomes of post-operative pain and cosmetic satisfaction were better than the standard four port procedure with equivalent operative time.