Three-Port Versus Standard Four-Port Laparoscopic Cholecystectomy: A Randomized Controlled Clinical Trial in a Community-Based Teaching Hospital in Eastern Nepal

Article Overview
The prevalence of laparoscopic cholecystectomies has increased in frequency leading to an increase in both surgeoi experience and technical refinements, specifically the number of ports used and their size. The 3-port laparoscope cholecystectomy has already been established as being safe. The design of this study sought to determine if ther were any additional advantages compared with the conventional 4-port laparoscopic cholecystectomy.

Method
A randomized trial of 75 consecutive patients undergoing elective cholecystectomies and assigned to receive either a 3-port cholecystectomy or the conventional 4-port

1. All patients received surgical tape over (ho 4 surgical        
2. One surgeon completed the majority of cases, incision areas. Surgical tape was maintained through 1 week follow-up to keep the therapy blinded.

The primary patient outcomes were postoperative pain at port sites (VAS1-10). analgesia requirements, post-op stay days to return to normal activity, success rate, and satisfaction score on surgery and scar. The success rate was assessed as no conversion to open cholecystectomy or conversion to 4-port in the 3-port group. Safety was assessed based on bile duct injury and excessive bleeding.