Three port versus four port laparoscopic cholecystectomy: a prospective comparative clinical study


  • Harish Chauhan Department of Surgery, SMIMER Medical College, Surat, Gujarat, India
  • Jenish Kothiya Department of Surgery, SMIMER Medical College, Surat, Gujarat, India
  • Jignesh Savsaviya Department of Surgery, SMIMER Medical College, Surat, Gujarat, India



Bile, Cholelithiasis, Laparoscopic cholecystectomy, Cystic artery, Cystic duct, Pneumoperitoneum


Background: Although, traditional laparoscopic cholecystectomy is performed using four-port technique, various modifications were made to further enhance the advantages of laparoscopic cholecystectomy. Aim of the study is to compare the results of three-port and four-port laparoscopic cholecystectomy at single centre in terms of technical feasibility, safety of the procedure, operative time, intra-operative complications, postoperative pain and post-operative analgesia requirement.

Methods: It was a prospective comparative study conducted in the department of surgery Smimer medical college Surat, India from July 2018 to July 2019. The study was performed on all adult patients with ultrasound documented cholelithiasis. The total number of patients studied was 50 which were divided into two groups of 25 each.

Results: Demographic data were comparable for both study groups. Patients in the 3-port group had shorter mean operative time (47.3±29.8 min versus 60.8±32.3 min) for the 4-port group (p=0.04). Post-operative requirement of analgesia was less in 3 port group as compared to 4 port group. Pain visual analog scale (VAS) score, intra operative complications, post- operative complications and return to normal activity were significant in our study. Hospital stay and patient satisfaction were non- significant.

Conclusions: The three-port technique is as safe as the standard four-port technique and can be a viable alternative to four port cholecystectomy with an advantage of less analgesic requirement, early post-operative ambulance, early oral feed, and better cosmetic results.


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