Comparative Study Between Standard Four-Port Versus Three-Port Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy (LC) has become the gold standard for the management of symptomatic gallstone disease. Modifications such as reducing the number of ports has been explored to improve patient outcomes. The objective is to compare the clinical outcomes of standard four-port versus three-port laparoscopic cholecystectomy. Material and Methods: A prospective randomized study was conducted on 96 patients with symptomatic cholelithiasis, divided equally into two groups: Group A (four-port LC) and Group B (three-port LC). Parameters evaluated included operative time, conversion to open surgery, postoperative complications, pain, hospital stay, return to normal activity, and patient satisfaction. Results: Mean operative time was significantly higher in Group B (63.89 ± 7.91 minutes) than Group A (57.10 ± 7.49 minutes). Postoperative pain scores were lower in Group B (VAS 4.67) compared to Group A (VAS 6.10). No conversions to open surgery were recorded. Group B also had a quicker return to normal activity (11.31 vs. 14.97 days) and shorter hospital stay (4.52 vs. 4.75 days). Conclusion: Three-port LC is as safe and effective as four-port LC, with added benefits of reduced pain and quicker recovery. It is a viable alternative in experienced hands. Keywords: Laparoscopic cholecystectomy, Three-port, Four-port, Cholelithiasis.