Clinical effects of different approaches to laparoscopic cholecystectomy

Objective To analyze the clinical effects of several different approaches to laparoscopic cholecystectomy. Methods A total of400 patients who received cholecystectomy in our hospital from January 2013 to September 2014 were divided into four groups according to the approaches to laparoscopy (n = 100 per group) : single-port laparoscopic cholecystectomy, two-trocar laparoscopic cholecystectomy, three-trocar laparoscopic cholecystectomy, and four-trocar laparoscopic cholecystectomy. All clinical data were systematically analyzed on six indicators: blood loss during surgery, operation time, time to ambulation after surgery, time to taking meal after surgery, length of hospital stay after surgery, and the degree of pain at 6 h after surgery (rating of pain scale) . The clinical effects of the different approaches were compared between the four groups. Results Significant differences were observed in the following indicators: the degree of pain at 6 h after surgery between the groups of single-port and two-trocar laparoscopic cholecystectomy [ (2. 7 ± 0. 4 vs 1. 9 ± 0. 8) , P = 0. 036]; operation time between the groups of single-port and three-trocar laparoscopic cholecystectomy [ (55. 6 ± 23. 5) min vs (36. 0 ± 24. 3) min, P =0. 028]; length of hospital stay between the groups of single-port and three-trocar laparoscopic cholecystectomy [ (3. 0 ± 2. 3) d vs (5. 2± 3. 3) d, P = 0. 042]. All other indicators showed no significant differences between groups (P > 0. 05) . Statistical analysis of the six indicators indicated that all four approaches did not significantly influence the incidence of surgical complications (P > 0. 05) . Conclusion All the four approaches to laparoscopic cholecystectomy are safe and feasible, but the operation techniques should be standardized, anatomical knowledge should be mastered, and any changes in the surgical situation should be strictly monitored. Before the surgery, the patients' wishes and their physical conditions should be considered to choose the appropriate surgical approach and improve the surgical safety.