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- Title
Two-port versus four-port laparoscopic cholecystectomy.
- Authors
Poon, C. M.; Chan, K. W.; Lee, D. W. H.; Chan, K. C.; Ko, C. W.; Cheung, H. Y.; Lee, K. W.
- Abstract
<bold>Background: </bold>Two-port laparoscopic cholecystectomy has been reported to be safe and feasible. However, whether it offers any additional advantages remains controversial. This study reports a randomized trial that compared the clinical outcomes of two-port laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy.<bold>Methods: </bold>One hundred and twenty consecutive patients who underwent elective laparoscopic cholecystectomy were randomized to receive either the two-port or the four-port technique. All patients were blinded to the type of operation they underwent. Four surgical tapes were applied to standard four-port sites in both groups at the end of the operation. All dressings were kept intact until the first follow-up 1 week after surgery. Postoperative pain at the four sites was assessed on the first day after surgery using a 10-cm unscaled visual analog scale (VAS). Other outcome measures included analgesia requirements, length and difficulty of the operation, postoperative stay, and patient satisfaction score on surgery and scars.<bold>Results: </bold>Demographic data were comparable for both groups. Patients in the two-port group had shorter mean operative time (54.6 +/- 24.7 min vs 66.9 +/- 33.1 min for the four-post group; p = 0.03) and less pain at individual subcostal port sites [mean score using 10-cm unscaled VAS: 1.5 vs 2.8 ( p = 0.01) at the midsubcostal port site and 1.3 vs 2.3 ( p = 0.02) at the lateral subcostal port site]. Overall pain score, analgesia requirements, hospital stay, and patient satisfaction score on surgery and scars were similar between the two groups.<bold>Conclusion: </bold>Two-port laparoscopic cholecystectomy resulted in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port laparoscopic cholecystectomy. Thus, it can be recommended as a routine procedure in elective laparoscopic cholecystectomy.
- Subjects
CHOLECYSTECTOMY; LAPAROSCOPIC surgery; SURGICAL instruments; POSTOPERATIVE pain; ANALGESIA; PATIENT satisfaction; GALLSTONE diagnosis; GALLBLADDER tumors; COMPARATIVE studies; DIFFERENTIAL diagnosis; ENDOSCOPIC retrograde cholangiopancreatography; GALLBLADDER diseases; GALLSTONES; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; SURGICAL site infections; PILOT projects; PRODUCT design; EVALUATION research; PAIN measurement; RANDOMIZED controlled trials; VISUAL analog scale; DISEASE complications; DIAGNOSIS; EQUIPMENT &; supplies
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2003, Vol 17, Issue 10, p1624
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-002-8718-9