Prospective Comparative Study of the Safety and Severity of Postoperative Pain between the 3-port and 4-port Technique for Laparoscopic Cholecystectomy

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  • 腹腔鏡下胆囊摘出術における３孔式と４孔式の短期治療成績の前向き比較研究

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Abstract

<p>Purpose: We performed a prospective study to verify whether the safety or severity of postoperative pain could be affected by the number of trocars inserted for laparoscopic cholecystectomy (LC).</p><p>Methods: A total of 305 patients, after excluding subjects fitting the exclusion criteria, undergoing LC were randomly allocated to the 3-port LC group (n=153) or the 4-port LC group (n=152). The severity of postoperative wound pain was evaluated by the visual analogue scale (VAS) and by the number of postoperative analgesic doses required. The patient satisfaction was also estimated using VAS.</p><p>Results: There were no significant differences between the two groups in the VAS scores for wound pain, number of postoperative analgesic doses required, VAS scores for patient satisfaction, operation time, bleeding volume, or postoperative hospital stay. There was no case of conversion to laparotomy or intraoperative bile duct injury, although 3 cases of the 3-port LC group needed conversion to 4-port LC (2.0%).</p><p>Conclusion: Three-port LC was equivalent to 4-port LC in terms of the severity of postoperative pain and patient safety/satisfaction. Therefore, 3-port LC could potentially be established as the standard procedure for LC, with preparedness for additional trocar use in difficult cases.</p>

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