A Comparison Between the Three-Trocar Technique and the Four-Trocar Technique in Laparoscopic Cholecystectomy.
- Author:
Dong Eun PARK
1
;
Kwon Mook CHAE
;
Byung Joon SO
;
Kyung Keun LEE
Author Information
1. Department of Surgery, School of Medicine, Wonkwang University.
- Publication Type:Original Article
- Keywords:
Laparoscopic cholecystectomy;
Three-trocar technique;
Four-trocar technique
- MeSH:
Cholecystectomy, Laparoscopic*;
Cholecystitis, Acute;
Gallbladder;
Humans;
Length of Stay;
Postoperative Complications;
Prospective Studies;
Surgical Instruments
- From:Journal of the Korean Surgical Society
1998;54(5):709-714
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The laparoscopic cholecystectomy has been clearly established as the gold standard for the surgical treatment of calculous biliary diseases. The currently used most popular technique is the four-trocar technique. This prospective study was designed to examine whether or not three-trocar technique could be chosen as an alternative to the standard four-trocar technique. Prospective data were collected on 98 patients undergoing a laparoscopic cholecystectomy at Wonkwang University Hospital from December 1995 to July 1996. We excluded 40 cases of acute cholecystitis which under went an operative cholangiogram with conversion to the four-trocar method as unfit for this study. We evaluated all associated clinical factors for the three-trocar technique (28 cases); and the four-trocar technique (30 cases), and we analysed the operating time, the intraoperative gallbladder perforation, postoperative complications, the postoperative hospital stay, and the duration for compliants of pain. Between the two techniques, there were no significant differences in the operating times, the postoperative complications, the postopeative hospital stays, and the durations for complaint of pain. However, intraoperative gallbladder perforation more frequently developed in the three-trocar technique than in the four-trocar technique (4 cases versus 1 case, P=0.02). However, gallbladder perforation didn't cause a prolonged operating time; or any other postoperative complication. In our series, the three-trocar technique had results similar to those of the four trocar technique. Morever, the three trocar technique was more economical and had cosmetic advantages. We conclud that a qualified laparoscopic surgeon can choose the three-trocar technique as an alternative to the four-trocar technique.
