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Three-port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis.

Al-Azawi D, Houssein N, Rayis AB, McMahon D, Hehir DJ - BMC Surg (2007)

Bottom Line: There was no statistical difference between the three and four-port groups in terms of complications, conversion to open procedure (p = 0.6), and operating time (p = 0.4).The hospital stay was found to be related to the amount of opiates consumed (p = 0.0001) and was significantly shorter in the three-port LC group (p = 0.005).Three-port LC is a safe procedure for AC and CC in expert hands.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of surgery, Royal College of Surgeons in Ireland, Dublin Ireland. dhafir66@hotmail.com

ABSTRACT

Background: Several modifications have been introduced to laparoscopic cholecystectomy (LC). The three-port technique has been practiced on a limited scale. Our aim was to compare the three-port and four-port LC in acute (AC) and chronic cholecystitis (CC).

Methods: The medical records of 495 patients who underwent LC between September 1999 and September 2003 were reviewed. Variables such as complications, operating time, conversion to open procedure, hospital stay, and analgesia requirements were compared.

Results: Two hundred and eighty-three patients underwent three-port LC and 212 patients underwent four-port LC. In total, 163 (32.9%) patients were diagnosed with AC and 332 (67.1%) with CC by histology. There was no statistical difference between the three and four-port groups in terms of complications, conversion to open procedure (p = 0.6), and operating time (p = 0.4). Patients who underwent three-port LC required less opiate analgesia (pethidine) than those who underwent four-port LC (p = 0.0001). The hospital stay was found to be related to the amount of opiates consumed (p = 0.0001) and was significantly shorter in the three-port LC group (p = 0.005).

Conclusion: Three-port LC is a safe procedure for AC and CC in expert hands. The procedure offers considerable advantages over the traditional four-port technique in the reduction of analgesia requirements and length of hospital stay.

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Related in: MedlinePlus

pethidine requirement. The Bar chart shows the percent of patients received pethidine (mg) in the first 48 hours after surgery. The black bars represent three-port LC patients while the grey bars represent four-port group, means are 167.23 mg and 210.73 mg respectively p = 0.0001.
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Figure 1: pethidine requirement. The Bar chart shows the percent of patients received pethidine (mg) in the first 48 hours after surgery. The black bars represent three-port LC patients while the grey bars represent four-port group, means are 167.23 mg and 210.73 mg respectively p = 0.0001.

Mentions: The average (mean) amount of pethidine consumed by each patient during the first 48 hours after three-port and four-port LC were 167.23 mg and 210.73 mg respectively. The amount of diclofenac consumed for the same period was found to only relate to whether the patient was acute or chronic (p = 0.001). The amount of pethidine, however, was found to have a significant relationship to whether three- or four-port surgery was performed p = 0.0001, figure 1. The average verbal pain scale of three port LC patients was found to be significantly lower than four port LC patients p = 0.003, table 2.


Three-port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis.

Al-Azawi D, Houssein N, Rayis AB, McMahon D, Hehir DJ - BMC Surg (2007)

pethidine requirement. The Bar chart shows the percent of patients received pethidine (mg) in the first 48 hours after surgery. The black bars represent three-port LC patients while the grey bars represent four-port group, means are 167.23 mg and 210.73 mg respectively p = 0.0001.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1919351&req=5

Figure 1: pethidine requirement. The Bar chart shows the percent of patients received pethidine (mg) in the first 48 hours after surgery. The black bars represent three-port LC patients while the grey bars represent four-port group, means are 167.23 mg and 210.73 mg respectively p = 0.0001.
Mentions: The average (mean) amount of pethidine consumed by each patient during the first 48 hours after three-port and four-port LC were 167.23 mg and 210.73 mg respectively. The amount of diclofenac consumed for the same period was found to only relate to whether the patient was acute or chronic (p = 0.001). The amount of pethidine, however, was found to have a significant relationship to whether three- or four-port surgery was performed p = 0.0001, figure 1. The average verbal pain scale of three port LC patients was found to be significantly lower than four port LC patients p = 0.003, table 2.

Bottom Line: There was no statistical difference between the three and four-port groups in terms of complications, conversion to open procedure (p = 0.6), and operating time (p = 0.4).The hospital stay was found to be related to the amount of opiates consumed (p = 0.0001) and was significantly shorter in the three-port LC group (p = 0.005).Three-port LC is a safe procedure for AC and CC in expert hands.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of surgery, Royal College of Surgeons in Ireland, Dublin Ireland. dhafir66@hotmail.com

ABSTRACT

Background: Several modifications have been introduced to laparoscopic cholecystectomy (LC). The three-port technique has been practiced on a limited scale. Our aim was to compare the three-port and four-port LC in acute (AC) and chronic cholecystitis (CC).

Methods: The medical records of 495 patients who underwent LC between September 1999 and September 2003 were reviewed. Variables such as complications, operating time, conversion to open procedure, hospital stay, and analgesia requirements were compared.

Results: Two hundred and eighty-three patients underwent three-port LC and 212 patients underwent four-port LC. In total, 163 (32.9%) patients were diagnosed with AC and 332 (67.1%) with CC by histology. There was no statistical difference between the three and four-port groups in terms of complications, conversion to open procedure (p = 0.6), and operating time (p = 0.4). Patients who underwent three-port LC required less opiate analgesia (pethidine) than those who underwent four-port LC (p = 0.0001). The hospital stay was found to be related to the amount of opiates consumed (p = 0.0001) and was significantly shorter in the three-port LC group (p = 0.005).

Conclusion: Three-port LC is a safe procedure for AC and CC in expert hands. The procedure offers considerable advantages over the traditional four-port technique in the reduction of analgesia requirements and length of hospital stay.

Show MeSH
Related in: MedlinePlus