| 摘要 |
Purpose: A total of 1276 laparoscopic cholecystectomies (LCs) using two‑, three‑, and four‑port methods were analyzed to evaluate the feasibility and effectiveness of two and three‑port LCs in management for acute or elective gallstone disease when compared with four‑port LC.
Materials and Methods: A between‑group comparison was performed on the difference of operation time, postsurgery admission days, postsurgery daily pain score between acute or elective surgery or different procedures.
Results: Proportion of four‑port LC was significant high in acute then in elective surgery (93.3% vs. 79.0%; P = 0.001). In elective surgeries, difference among mean operative time of two‑, three‑, and four‑port
LC (36.76, 34.72, and 27.32 min, respectively) was statistically significant (P = 0.001). Three‑port LC showed a significant lowest mean pain score (1.887; 1 to 10 point pain score) on the first‑day post‑LC. (P = 0.04) Difference on the mean post‑LC hospitalization of two‑, three‑, and four‑port LCs (2.158, 2.141 and 2.412 days, respectively) were significant in elective (P = 0.001) while not significant in acute surgery (two‑, three‑, and four‑port LCs: 2.75, 2.778, and 3.097 days, respectively; P = 0.237).
Conclusions: Four‑port LC was the procedure of choice in acute surgery. The operative time was the shortest for four and longest for two‑port LC. Three‑port LC could be adopted using strategic selection (elective surgery) and conversion (with adding port) as safety guard for the benefits of less wound pain, decreased post‑LC admission days. |
