COMPARISON OF OUTCOME WITH THREE-PORT VERSUS CONVENTIONAL FOUR-PORT LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Objective: To compare the outcomes of three-port laparoscopic cholecystectomy (LC) with the conventional four-port LC approach.

Methodology: This randomized controlled trial was conducted from January 2025 to April 2025 in the general surgery unit of Allama Iqbal Teaching Hospital, DG Khan. Patients aged 25–60 years of either male or female gender, presenting with acute cholecystitis, having ≤ 7-days symptom duration and planned for LC were included. The patients were randomly assigned to 3-port LC (Group A) and 4-port LC group (Group B). VAS pain score at 24 hours, total duration of oral analgesia and time to return to daily activities were primary study outcomes.

Results: Group A had a mean age of 41.1 (±8.6) years while Group B had a mean age of 39.8 (±9.3) years (p-value of 0.57). The Visual Analog Scale (VAS) score measured 24 hours post-operation was significantly lower in Group A, 1.7 ± 0.4 versus 2.9 ± 0.7 in group B (p-value <0.0001). Moreover, the duration of oral analgesia was notably reduced for Group A, averaging 3.4 ± 0.61 days versus 4.2 ± 0.9 days in group B (p-value <0.0001. Additionally, Group A experienced a quicker return to daily activities, 4.6 ± 0.7 days versus 5.5 ± 1.3 days in group B (p-value 0.001).

Conclusion: The three-port LC is safe and is linked to improved post-operative pain outcomes and a quicker return to daily life activities compared to four-port LC.