title: Two-port laparoscopic cholecystectomy with modified suture retraction of the fundus: A practical approach.
abstract: BACKGROUND
  Although transumbilical single incision laparoscopic cholecystectomy (SILC) has been demonstrated to be superior cosmetic, it is only limited to simple cases at present. In complex cases, the standard four- or three-port LC is still the treatment of choice.
  
  
  OBJECTIVE
  To summarize the clinical effect of a modified technique in two-port LC.
  
  
  METHODS
  A consecutive series of patients with benign gallbladder diseases admitted to the provincial teaching hospital who underwent LC in the past 4 years were included. A modified two-port LC was the first choice except for those requiring laparoscopic common bile duct exploration (LCBDE).
  
  
  METHODS
  The operation was done with suture retraction of the fundus by a needle-like retractor. The patients' data, including the operative time, time consumed by gallbladder retraction, operative bleeding, conversion rate, rate of adding trocars, and postoperative complications were recorded.
  
  
  METHODS
  Data were expressed as percentage and mean with standard deviation.
  
  
  RESULTS
  Total 107 patients with chronic calculous cholecystitis (N = 61), acute calculous cholecystitis (N = 43), and cholecystic polyps (N = 3) received two-port LC. The procedure was successful in 99 out of 107 cases (success rate, 92.5%), and a third trocar was added in the remaining 8 cases (7.5%) due to severe pathological changes. The operative time was 47.2 (±13.21) min. There was no conversion to open surgery.
  
  
  CONCLUSIONS
  Two-port LC using a needle-like retractor for suture retraction of the gallbladder fundus is a practical approach when considering the safety, convenience, and indications as well as relatively minimal invasion.
authors.affiliation: Department of Hepatobiliary Surgery, the People's Hospital of Ningxia Autonomous Region, Yinchuan, Ningxia, China.
authors.forename: Ming G
authors.initials: MG
authors.lastname: Tian
authors.forename: Pei J
authors.initials: PJ
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Yang
authors.forename: Fan J
authors.initials: FJ
authors.lastname: Shang
authors.forename: J
authors.initials: J
authors.lastname: Zhan
keywords: Needle-like retractor; suture retraction of the fundus; two-port LC
references.citation: J Laparoendosc Adv Surg Tech A. 1998 Oct;8(5):303-8
references.pmid: 9820723
references.citation: J Laparoendosc Adv Surg Tech A. 2001 Apr;11(2):85-8
references.pmid: 11327132
references.citation: Br J Surg. 1997 May;84(5):695
references.pmid: 9171771
references.citation: J Minim Access Surg. 2011 Jan;7(1):17-23
references.pmid: 21197237
references.citation: World J Surg. 2011 May;35(5):967-72
references.pmid: 21359686
references.citation: Am J Surg. 2011 Mar;201(3):369-72; discussion 372-3
references.pmid: 21367381
references.citation: Surg Endosc. 2011 Feb;25(2):404-7
references.pmid: 20607565
references.citation: Surg Endosc. 2003 Oct;17(10):1624-7
references.pmid: 12874694
references.citation: World J Gastroenterol. 2010 Jan 14;16(2):270-4
references.pmid: 20066749