Three-port vs standard four-port laparoscopic cholecystectomy: a prospective randomized double-blind trial

Objective To report a randomized trial in comparing the clinical outcomes of three-port LC versus standard four-port LC. Methods From March 2001 to August 2004, four hundred eonsecutive patients who underwent elective LC were randomized to receive either the three-port or the four-port technique. All patients were blinded to the type of operation they underwent. Postoperative overall pain and ineisional pain at different sites were assessed on the first day after surgery using the Prince-Heno＇ scale. Other nutcome measures included length and success of the operation, analgesia requirements, postoperative eomplicalions, postoperative stay, and the cosmetic resuhs. Results There was no difference between the two groups in age, sex, weight or other diseases. In terms of outcome, patients in the three-port group had less pain at individual subeostal port sites and better cosmetic results. Success rate, mean operative time, complications, subxiphoid port and overall pain score, analgesia requirements, and postoperative hospital stay were similar between these two groups. Conclusion Three-port LC resuhed in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port LC. The three-port technique is as safe as the standard four-port procedure for LC. Thus, it can be recommended as a routine procedure in elective LC. Key words: Laparoseopic cholecystectomy;  Three-port technique