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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

the correlation between the hospital stay and the amount of pethidine required. The scatter plot illustrates the linear correlation between hospital stay and the amount of pethidine consumed by patients (red plots resemble three-port group and the black plots represent four-port group).
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Figure 3: the correlation between the hospital stay and the amount of pethidine required. The scatter plot illustrates the linear correlation between hospital stay and the amount of pethidine consumed by patients (red plots resemble three-port group and the black plots represent four-port group).

Mentions: The mean operating time for the three-port LC procedure was 46.1 minutes versus 48.9 minutes for the four-port technique. No significant difference between the two techniques (p = 0.4). However, when length of hospital stay was examined, there was a significant decrease of hospital stay in the three-port technique compared to the traditional LC: mean hospital stay was 2.8 days and 3.7 days, respectively p = 0.005, figure 2. Bivariate correlation showed that the length of hospital stay was significantly related to the amount of pethidine consumed by patients in both groups p = 0.0001, figure 3.


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)

the correlation between the hospital stay and the amount of pethidine required. The scatter plot illustrates the linear correlation between hospital stay and the amount of pethidine consumed by patients (red plots resemble three-port group and the black plots represent four-port group).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: the correlation between the hospital stay and the amount of pethidine required. The scatter plot illustrates the linear correlation between hospital stay and the amount of pethidine consumed by patients (red plots resemble three-port group and the black plots represent four-port group).
Mentions: The mean operating time for the three-port LC procedure was 46.1 minutes versus 48.9 minutes for the four-port technique. No significant difference between the two techniques (p = 0.4). However, when length of hospital stay was examined, there was a significant decrease of hospital stay in the three-port technique compared to the traditional LC: mean hospital stay was 2.8 days and 3.7 days, respectively p = 0.005, figure 2. Bivariate correlation showed that the length of hospital stay was significantly related to the amount of pethidine consumed by patients in both groups p = 0.0001, figure 3.

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