[Minimization of approach at laparoscopic cholecystectomy].

OBJECTIVE

The aim of the study was to estimate the influence of the amount of endoscopic approaches on effectiveness of laparoscopic cholecystectomy.

METHODS

For the purpose of comparative evaluation of the results of surgical treatment of a three- and fourport laparoscopic approach was a retrospective analysis of case histories of 118 patients. Patients were divided into two groups: operated by using three laparoscopic approaches (60 patients) and unused optional fourth trocar (58 patients). One of the important stages of scientific research was histological morphology characteristic of the removed gallbladder, which was performed in 118 patients who underwent minimally invasive operations. For subjective assessment of the manifestations of pain syndrome used the conventional visual analog scale of pain (VAS).

RESULTS

60 patients underwent three-port laparoscopic cholecystectomy (the main group) and 58 patients underwent four-port LC (group of comparison). In the main group 53 (88.3%) patients showed absence of any pain, and only 3 from them complained of existence easy and 4--moderate pain respectively for the 7th day after surgical intervention. In group of comparison these indicators made: respectively 50 (86.2%), 2 and 6 people. Terms of hospitalization and disability were relatively lower at the minimum number of ports: respectively 3.2 and 4.4 days. In the main group duration of disability made 8.5 days against 10.6 days in group of comparison.

CONCLUSION

Reducing the number of laparoscopic approach significantly reduced the frequency of clinical manifestations of pain, achieved maximum cosmetic effect, significantly shortens postoperative rehabilitation period, and comes earlier activation and rehabilitation of patients.