Three-port laparoscopic cholecystectomy: A retrospective study of the cases in 2007

Introduction: Classic laparoscopic cholecystectomy (LC) is performed via 4 ports. Increasing surgical experience and the intention of minimal invasivity established the claim of the three-port LC. Comparison of the three-port versus four-port approaches is the aim of this study.

Method: In 2007, 290 LCs were performed at the 1st Department of Surgery of the Semmelweis University, among them 10 via three ports. Data analysis was retrospective. Significance levels were set with the chi-probe and the Fischer probe.

Results: Demographic data and past medical records were comparable for both groups. No significant differences were found between the three-port and four-port approaches in the operative time (46+/-6min versus 51+/-22min) and in the hospital stay (2.3+/-1.2 days versus 2.2+/-1.5 days). Intra-operative complications (bleeding, gall bladder perforation, gallstone spillage) and conversion did not occur in patients who underwent a three-port LC. Those inconveniencies were noticed only in 0.8–5.5% of the four-port LC operations, thus the discrepancy of these parameters did not appear to be significant in the two groups.

Discussion: Our data and the literature confirm the safe feasibility of the three-port laparoscopic cholecystectomy. Further investigations are necessary to judge the advantage of this method over the four-port approach. Assessment of the patients' satisfaction, the demand of postoperative analgetics, the effect of the learning curve and additional refinement of currently analyzed parameters would justify the achievement of a randomized prospective study.