title: Postoperative port-site pain after gall bladder retrieval from epigastric vs. umbilical port in laparoscopic cholecystectomy: a randomized controlled trial.
abstract: OBJECTIVE
  To determine whether gall bladder (GB) retrieval from umbilical port is associated with more pain at port site as compared to GB retrieval from epigastric port in adult patients undergoing four port elective laparoscopic cholecystectomy at a tertiary care hospital.
  
  
  METHODS
  Adult patients, who were undergoing elective laparoscopic cholecystectomy during a six month period in 2010 at our institute, were randomized to either group A (n = 60, GB retrieval through epigastric port) or group B (n = 60, GB retrieval through umbilical port). VAS for pain was assessed by a registered nurse at 1, 6, 12, 24 and 36 h after surgery.
  
  
  RESULTS
  The VAS for pain at umbilical port was less than epigastric port at 1, 6, 12, 24 and 36 h after surgery (5.9 ± 1.1 vs. 4.1 ± 1.5, 4.6 ± 0.94 vs. 3.5 ± 1.05, 3.9 ± 0.85 vs. 2.4 ± 0.79, 3.05 ± 0.87 vs. 2.15 ± 0.87, respectively) and the difference was statistically significant (p-value < 0.001). Multiple linear regression was done for port site pain at 24 h and the VAS at umbilical port was less than epigastric port with VAS difference of 0.9 after adjusting for age, sex, duration of surgery and additional analgesia use (r2 = 0.253, p-value < 0.001).
  
  
  CONCLUSIONS
  Gall bladder retrieval from umbilical port is associated with lower port site pain than GB retrieval from epigastric port in patients undergoing elective laparoscopic cholecystectomy. We recommend umbilical port for gall bladder retrieval.
authors.affiliation: Aga Khan University Hospital, Karachi, Pakistan. nadeem.siddiqui@aku.edu
authors.forename: Nadeem Ahmed
authors.initials: NA
authors.lastname: Siddiqui
authors.forename: Rizwan
authors.initials: R
authors.lastname: Azami
authors.forename: Ghulam
authors.initials: G
authors.lastname: Murtaza
authors.forename: Sana
authors.initials: S
authors.lastname: Nasim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome; D014472:Umbilicus; D055815:Young Adult