A Prospective Comparison Study of the Two-port and Three Port Techniques for Performing Laparoscopic Cholecystectomy

Kim, Young; Won, Tae Wan; Park, Dong Eun; Chae, Kwon Mook

Abstract

PURPOSE
Various methods have evolved for laparoscopic cholecystectomy: the four-port, three-port or two-port methods. Some authors have recently recommended 2 port laparoscopic cholecystectomy as a useful method. We compared the clinical characteristics of the two-port method and the three-port method, and we estimated the usefulness of each method.
METHODS
We performed a prospective analysis of 40 patients who underwent laparoscopic cholecystectomy by a single surgeon from September 2008 to January 2009. The two port and 3 port techniques were alternatively done during the study period by one surgeon who had adequate experience with laparoscopic surgery at Wonkwang university hospital. We compared the two groups according to the parameters of the operation time, the intraoperative complications, the conversion rate, the postoperative complications, the postoperative hospital stay, the pain at the trocar sites and the patients' satisfaction.
RESULTS
There were significant differences between the two and three port groups in terms of the mean operation time, the conversion rate and the intraoperative events. The mean operation time (2 port; 38.95+/-10 min., 3 port; 23.25+/-5 min.: p<0.01), conversion rate (2 port; 5 cases, 3 port; 0 case: p=0.016) and there were fewer intraoperative events using the three port technique that that of the two port technique (2 port; 14 events, 3 port; 2 events: p<0.01). There were no significant differences of the trocar site pain, the hospital stay and the patients' satisfaction.
CONCLUSION
Considering our results, the tree port technique could be regarded as the optimal surgical technique compared to the 2 port technique for performing laparoscopic cholecystectomy, or at least until new instruments for gall bladder traction and new port were not developed.