Three port laparoscopic cholecystectomy with or without a marionette sling: A randomized controlled trial. | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 43, Issue 4, October 2024, Page 1416-1420 PDF (346.21 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/EJSUR.2024.291279.1081 | ||||
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| Author | ||||
| Mahmoud A. Mahmoud* | ||||
| Department of General Surgery, Qena Faculty of Medicine, South Valley University, Qena, Egypt | ||||
| Abstract | ||||
| Objectives: To compare between the three-port cholecystectomy versus adding a marionette sling to the three-port cholecystectomy. Patients and Methods: We operated on 52 patients through a three-port (group T) cholecystectomy and operated on another 52 patients through a three-port plus a marionette sling inserted percutaneously through the gallbladder fundus (group M). Results: All the preoperative demographic data for patients of both groups were comparable. In group T, operative duration was 46±12 min versus 47±11 min for group M (nonsignificant differences). The rate of conversion to four-port technique was (9.6%) in group T versus (1.9%) in group M (a statistically significant difference). Bile leakage occurred in only one (1.9%) patient in group T versus seven (13.5%) patients in group M (a statistically significant difference). Patients of group T were discharged within 15±2 h of the operation while patients of group M were discharged within 15±3 h. (a statistically nonsignificant difference). In group T, the amount of fluid discharged in patient’s drain was about 100±20 ml while in group M patient’s drain discharged about 150±50 ml of fluids per patient (a statistically significant difference). The incidence of SSI (Surgical Site Infection) in group T was 5.8% (3/52 patients) but in group M the incidence of SSI was much higher than that (17.3%, 9/52 patients). Infections were mainly at the third port (drain site). Conclusion: Adding an extra marionette sling to the three-port cholecystectomy decreased the rate of conversion to fourport cholecystectomy but it was associated with an increased incidence of superficial SSI. | ||||
| Keywords | ||||
| Laparoscopic cholecystectomy; marionette sling; three port | ||||
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