Three port versus four port Laparoscopic Cholecystectomy: A Comparative study.

Four port laparoscopic cholecystectomy has been a standard procedure for removal of gall bladder. Each additional port gives more morbidity to the patient. Research continues to devise procedures which are more patient friendly. Reducing the number and size of ports has been postulated to be superior in terms of requirement of analgesics, hospital stay, cosmesis and cost. AIM: Our aim was to compare the three- port and four- port laparoscopic cholecystectomy in terms of Operating time, Safety of the procedure, Need for the additional ports, Postoperative pain, Hospital stay and Cosmesis. MATERIALS AND METHODS: 200 patients with symptomatic gall stone disease were managed by laparoscopic cholecystectomy (LC) from August2010 to September2014. 100 patients were subjected to three port and 100 patients to four port LC. In three port laparoscopic cholecystectomy 5mm port along anterior axillary line was omitted which is usually used for retracting the fundus of gall bladder so as to expose calot’s traingle. RESULTS: There was no statistical difference between the two groups in terms of complications, conversion to open procedure (p=1) operative time (p=0.096), and hospital stay (p=0.730). However patients who undergone three-port laparoscopic cholecystectomy had less pain and required less analgesia than those who undergone four port LC (p<0.05), also three-port LC is less expensive and is cosmetically better than four port laparoscopic cholecystectomy. Conclusion: Three-port LC is a safe procedure in expert hands and resulted in less port site pain ,required less analgesia ,is cosmetically better and cost effective.