Risk Factors for Difficult Three-Port Laparoscopic Cholecystectomy.

Area of Science:

• Minimally Invasive Surgery
• Gastrointestinal Surgery
• Surgical Techniques

Background:

• Standard laparoscopic cholecystectomy (LC) uses four ports.
• Reduced-port surgery offers benefits, but evidence for challenging cases is limited.
• This study investigates factors complicating reduced-port LC.

Purpose of the Study:

• To explore factors that complicate three-port laparoscopic cholecystectomy (LC).
• To identify risk factors for non-complete reduced-port LC.
• To guide surgical decisions in challenging LC cases.

Main Methods:

• Retrospective analysis of 47 patients undergoing three-port LC.
• Patients categorized into complete or non-complete LC groups.
• Risk factors for non-complete LC analyzed via univariate analysis.

Main Results:

• Six patients (12.8%) had non-complete LC.
• Preoperative gallbladder drainage and lower BMI were associated with non-complete LC.
• Non-complete LC correlated with longer operative time, increased blood loss, and longer hospital stay.

Conclusions:

• Three-port LC is challenging in patients with preoperative gallbladder drainage and gallbladder neck scarring.
• Adequate support and early conversion to subtotal or open cholecystectomy are crucial for high-risk patients.
• Further research is needed to identify significant risk factors for non-complete LC.