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Research Paper | Surgery | Volume 15 Issue 4, April 2026 | Pages: 579 - 583 | India
A Prospective Randomized Control Study Comparing Standard 4 Port Laparoscopic Cholecystectomy Versus Reduced Port Size Laparoscopic Cholecystectomy for Gall Stone (Cholelithiasis)
Abstract: Background: Gallstone disease (cholelithiasis) is a common health problem that often necessitates surgical removal of gallbladder (cholecystectomy). Laparoscopic cholecystectomy (LC) is gold standard for treating symptomatic gallstone disease, typically performed using a four-port technique. Recent advances in minimally invasive surgery have led to development of reduced port size laparoscopic cholecystectomy (RPLC), which aims to minimize the number and size of ports used, potentially offering benefits such as reduced postoperative pain, improved cosmetic outcomes, and faster recovery. Objective: This prospective randomized control study aims to compare the clinical outcomes of standard 4-port laparoscopic cholecystectomy (SLC) with reduced port size laparoscopic cholecystectomy (RPLC) for the treatment of gallstone disease. Methods: A total of 60 patients with cholelithiasis, fulfilling the inclusion criteria, were randomly assigned to either Group A (SLC) or Group B (RPLC), with 30 patients in each group. Both techniques involved laparoscopic removal of the gallbladder, with the only difference being the size of the epigastric and lateral ports. Intraoperative and postoperative outcomes were evaluated, including operative time, postoperative pain (measured using the Visual Analogue Scale), cosmetic outcomes (assessed using the Scar Cosmesis Assessment and Rating Scale), complication rates, patient satisfaction, and hospital stay. Data were analyzed using statistical methods, and significance was determined at a p-value < 0.05. Results: The RPLC group (Group B) had significantly longer operative times compared to the SLC group (32.27 ± 5.55 min vs. 26.90 ± 3.96 min, p = 0.0001). However, postoperative pain was consistently lower in Group B at 6, 12, and 24 hours postoperatively, with statistically significant differences. At the 7-day follow-up, all patients were pain-free. Cosmetic outcomes, particularly scar appearance, were significantly better in Group B, with lower scar scores at both the epigastric and lateral port sites (p < 0.0001). There were no significant differences in complication rates between the two groups. Hospital stay was shorter in Group B (mean 1.37 days vs. 1.80 days, p = 0.049). Conclusion: Reduced port size laparoscopic cholecystectomy (RPLC) offers significant advantages over standard 4-port laparoscopic cholecystectomy (SLC) in terms of reduced postoperative pain and improved cosmetic outcomes, without compromising safety. Although RPLC requires longer operative times, it is a feasible and patient-friendly option, particularly for those prioritizing cosmetic results and quicker recovery. These findings support the use of RPLC as a viable alternative to standard techniques in selected patients.
Keywords: Cholelithiasis, laparoscopic cholecystectomy, reduced port size, postoperative pain, cosmetic outcomes, randomized controlled trial
How to Cite?: Dr. Yogesh Sadh, Dr. R. K. Kajla, Dr. Dinesh Bhamu, Dr. Mahavir Prasad, Dr. Radhika Agarwal, Dr. Arnav Dayal, Dr. Sanjay Choudhary, Dr. Surendra Kumar Jat, "A Prospective Randomized Control Study Comparing Standard 4 Port Laparoscopic Cholecystectomy Versus Reduced Port Size Laparoscopic Cholecystectomy for Gall Stone (Cholelithiasis)", Volume 15 Issue 4, April 2026, International Journal of Science and Research (IJSR), Pages: 579-583, https://www.ijsr.net/getabstract.php?paperid=SR26408222331, DOI: https://dx.dx.doi.org/10.21275/SR26408222331