A comparative study of the incidence of pain and infection in gall bladder extraction via umbilical and epigastric port

Abstract

Background: In laparoscopic cholecystectomy, gall bladder extraction via different ports has always been a matter of concern for the surgeons. This study is designed so as to determine the difference in the rate of pain and infection in gall bladder extraction via umbilical and epigastric port.Methods: A prospective randomized study was done from January 2015 to December 2015 at S. N. Medical College, Agra in which 200 patients of cholelithiasis were considered. The patients were randomly selected in the operation theatre for gall bladder extraction via epigastric port (designated as Group-A with n = 100 patients) and gall bladder extraction via umbilical port (designated as Group-B with n = 100 patients).Results: Post-operative pain at 24 hours, in terms of VAS was 3.67±1.42 in Group-A while 2.47±1.17 in Group-B with 10 being the worst pain. The p-value was calculated as .000048. The result is significant at p< .05. A total of eight patients out of two hundred patients suffered port site infections amongst which five were from Group-A (5%) and three were from Group-B (3%).Conclusions: This study thus indicates that in laparoscopic cholecystectomy, gall bladder retrieval through the umbilical port is a better alternative to gall bladder extraction via epigastric port in terms of post-operative pain and port site infection. Our study recommends gall bladder extraction via umbilical port rather than epigastric port.

A comparative study of postoperative port-site pain after gallbladder retrieval from umbilical versus epigastric ports in laparoscopic cholecystectomy

“…(47.49 ± 9.4 vs. 46.84 ± 5.60). [9] However, the average age in this study was lesser as compared to the other studies.…”

“…There was predominance of female population in this study (69%) comparable to the series by Shakya et al . (75% female),[9] Siddiqui et al . (76% female),[8] Bashir et al .…”

“…Similar results were obtained by Siddiqui et al . [8] and Shakya et al .,[9] where they concluded that umbilical port was better for GB retrieval in terms of postoperative pain.…”

Gallbladder Retrieval From Epigastric Versus Umbilical Port in Laparoscopic Cholecystectomy: A PRISMA-Compliant Meta-Analysis

“…All included studies provided data about age, gender, and postoperative pain on VAS 24 hours after surgery. [16][17][18][19][20][21][22] The studies of Siddiqui et al 16 and Hajong et al 22 provided also results in terms of pain on VAS at 1, 6, and 12 hours after surgery. Data about the incidence of hernia were reported by Kaya et al 19 and Li et al, 21 while the rate of infections was reported by Kaya et al, 19 Shakya et al, 20 and Li et al 21 Finally, Siddiqui et al 16 and Li et al 21 reported the total length of the cholecystectomies, while Ahmad et al, 17 Bashir et al, 18 Shakya et al, 20 and Hajong et al 22 reported the time to retrieve the gallbladder only.…”

“…A port enlargement was described in the study of Kaya et al 19 only (6/60 vs 11/60 in the epigastric and umbilical extraction site, respectively), while Siddiqui et al 16 enlarged routinely the epigastric port to extract the gallbladder, and Hajong et al 22 excluded patients requiring a port dilatation. Finally, the abdominal fascia was sutured in the study of Siddiqui et al 16 and Shakya et al 20 at the umbilical port site, while Kaya et al 19 performed the closure in all port site >10 mm. 16 Ahmad Et al 17 Bashir Et al 18 Kaya Et al 19 Shakya Et al 20 Li Et al 21 Hajong Et al 22 Type of study The risk of bias of the selected studies is reported in Figure 2.…”