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Laparoscopic cholecystectomy utilizing three ports: preliminary study

Laparoscopic cholecystectomy (LC) is the treatment of choice for gallbladder stones. The operative technique of the LC reported by most authors requires the use of four ports. The aim of this study was to appears our initial trial with the LC using three ports with the objective of increase the mobility of the surgeons 's team and reduce the procedure charge. From september 1994 to august 1996, 169 three portals LC were carried out, 133 (78.6%) were females and 36 (21.3%) were males. The median age was45,6 years, ranging from 7 to 91 years. The 169 three portals LC performed, 163 (96.4%) were sucessful, three (1.8%) were necessary to use the fourth port and three (1.8%) were converted for open cholecystectomy due choledocolithiasis. The median time of surgery was 78.4 minutes, ranging from 23 to 170 minutes. Perioperative complications occurred in six (3.6%) cases: cystic duct rupture - two (1.2%), epigastric portal hemorrhage -two (1.2%), gallbladder's bed hemorrhage - one (0.6%); subcutaneous emphysema - one (0.6%). Post-operative complications occurred in five cases (3.0%): infection of the navel portal- two (1.8%), prolonged ileus - one (0.6%), choleperitoneum - one (0.6%); residual choledocolithiasis - one (0.6%). No death occurred. The authors concluded that three portals LC offers advantages over four portals LC for allows a higher mobility of the surgeons’s team, uses smaller amount of laparoscopic instruments which suggests reduced procedure charge and allows better aesthetical result.

Laparoscopic cholecystectomy; Operative Technique; Laparoscopy


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