Abstract
Background: Since the first laparoscopic cholecystectomy (LC) was reported in 1990, it has met with widespread acceptance as a standard procedure using four trocars. The fourth (lateral) trocar is used to grasp the fundus of the gallbladder so as to expose Calot’s triangle. It has been argued that the fourth trocar is not necessary in most cases. Therefore, the aim of this study was to compare the three-port vs the four-port technique. Methods: Between 1998 and 2000, 200 consecutive patients undergoing elective LC for gallstone disease were randomized to be treated via either the three- or four-port technique. Results: There was no difference between the two groups in age, sex, or weight. In terms of outcome, there was no difference between the two groups in success rate, operating time, number of oral analgesic tablets (paracetamol), visual analogue score, or postoperative hospital stay; however, the three-port group required fewer analgesic injections (nalbuphine) (0.4 vs 0.77, p = 0.024). Conclusion: The three-port technique is as safe as the standard four-port one for LC. The main advantages of the three-port technique are that it causes less pain, is less expensive, and leaves fewer scars.
Similar content being viewed by others
References
F Dubois P Icard G Berthelot H Levard (1990) ArticleTitleCoelioscopic cholecystectomy: preliminary report of 36 cases. Ann Surg 211 60–62 Occurrence Handle1:STN:280:By%2BC3czmt1E%3D Occurrence Handle2294845
PL Leggett R Churchman-Winn G Miller (2000) ArticleTitleMinimizing ports to improve laparoscopic cholecystectomy. Surg Endosc 14 32–36
LK Nathanson S Shimi A Cushchieri (1991) ArticleTitleLaparoscopic cholecystectomy: the Dundee technique. Br J Surg 78 155–159 Occurrence Handle1:STN:280:By6C1MfmvF0%3D Occurrence Handle1826623
G Navarr E Pozza S Occhionorelli P Cakotoro I Domini (1997) ArticleTitleOne wound laparoscopic cholecysectomy. Br J Surg 84 695 Occurrence Handle10.1046/j.1365-2168.1997.02586.x Occurrence Handle9171771
WT Ng (1998) ArticleTitleThree trocar laparoscopic cholecystectomy: a cautionary note. Surg Laparosc Endosc 8 159–160 Occurrence Handle10.1097/00019509-199804000-00018 Occurrence Handle1:STN:280:DyaK1c3is1ahtQ%3D%3D Occurrence Handle9566575
DO Olsen (1991) ArticleTitleLaparoscopic cholecystectomy. Am J Surg 161 339–344 Occurrence Handle1:STN:280:By6C2MfgvVY%3D Occurrence Handle1825754
T Otani T Kaji T Fukasawa T Osawa F Seki et al. (1998) ArticleTitleA flower-shaped cannula for three incision laparoscopic cholecystectomy. Surg Endosc 12 179–180 Occurrence Handle10.1007/s004649900625 Occurrence Handle1:STN:280:DyaK1c7ktVeltA%3D%3D Occurrence Handle9479739
K Slim D Pezet J Stencl Jr C Lechner SL Roux et al. (1995) ArticleTitleLaparoscopic cholecystectomy: an original three trocar technique. World J Surg 19 394–397 Occurrence Handle1:STN:280:ByqA28nitVA%3D Occurrence Handle7638995
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Trichak, S. Three-port vs standard four-port laparoscopic cholecystectomy . Surg Endosc 17, 1434–1436 (2003). https://doi.org/10.1007/s00464-002-8713-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-002-8713-1