Three-port Laparoscopic Cholecystectomy with Modification in Technique by Suture Retraction of Gallbladder

Abstract

Objective: With increasing surgeon experience, laparoscopic cholecystectomy was undergone many refinements including reduction in port number and size. Three-port LC has been reported to be safe and feasible in various clinical trial. This study reports my experience and feasibility of three-port LC with modification in techniques with suture retraction of gallbladder.

Materials and Methods: To assess the feasibility and safety of three-port LC with modification technique. This study underwent a prospective study with 119 patients at Krathumbaen Hospital, Samut Sakhon Province, Thailand between January 2009 and January 2014. The study offered a benefit of concealed tradition stitch in gallbladder placed for retraction over the conventional three-port LC. All cases were done by one surgeon and criteria of symptomatic gallstones (SGS) and chronic cholecystitis were included in our study.

Results: 119 cases of gallstones and chronic chelecystitis were subjected to modify techniques of three-port LC during 5 years period. 69 cases were female and 50 cases were male. The age range of our patients was between 19 and 79 years with the mean age of 51 years. In total 52 patients (43.6%) were diagnosed with SGS and 67 patients (56.4%) with chronic cholecystitis by histology. Mean operative time was 62 min (range 45-120 min). 3 cases were converted to open cholesystectomy and two case require an additional port in the right hypochondrium for retractor. Mean hospital stay was 3.6 days. 2 patients were developed post operative complication.

Conclusion: Three-port LC with our modification of the traction stitch in gallbladder placed for retraction received good result and patient satisfication especially in chronic cholecystitis patient due to thickening wall with contracted gallbladder. Thus, it can be recommended as a safe alternative procedure in elective LC especially chronic cholecystitis and long as long positional fold in symptomatic gallstones.