Laparoscopic cholecystectomy: an original three-trocar technique.
At present, laparoscopic cholecystectomy is the treatment of choice for gallbladder stones. The operating technique reported by most authors includes the use of four trocars. We report a group of 710 consecutive patients treated by an original three-trocar technique. The use of the fourth trocar was necessary in only 55 cases (8%). However, among 56 cases of acute cholecystitis the use of the fourth trocar was necessary in 14 cases (25%) (p < 0.01). Twenty-six laparoscopies were converted to open procedures (3.6%). Four common bile duct injuries were observed (0.5%): two of them among the 655 operations with three trocars (0.3%) and two after application of the fourth trocar at the beginning of the procedure because of dissection difficulties. Our results are similar to those using the "classic" four-trocar technique. Moreover, this technique is less expensive and allows one less scar.
Slim
K
K
Service de Chirurgie Générale et Digestive, Hotel Dieu, Clermont-Ferrand, France.
Pezet
D
D
Stencl
J
J
Lechner
C
C
Le Roux
S
S
Lointier
P
P
Chipponi
J
J
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy / Q000379:methods*; D002764:Cholecystitis / Q000601:surgery*; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments