Size does matter: A randomized trial comparing postoperative pain using 10mm VS 5mm umbilical ports in laparoscopic cholecystectomy.

Abstract

Objective: To accomplish the comparison of postoperative pain in laparoscopic cholecystectomy, using 10mm vs 5mm umbilical ports.

Methodology: Randomized controlled trial was performed from August 2014 till July 2015, with selection of patients of either gender above 18 years of age, undergoing laparoscopic cholecystectomy for symptomatic gallstones. Patients requiring cholecystectomy for gallbladder polyps or carcinoma, emergency surgery for acute cholecystitis, empyema, mucocele or perforated gallbladder and also patients having relative contraindications for laparoscopic cholecystectomy were excluded. They were randomly assigned, 50 patients in 10mm umbilical port group (group A) and 50 patients in which 5mm umbilical port was used (group B). Postoperative pain was assessed after 24 hours, at discharge and a month after surgery, using Numerical Analogue Scale (NAS).

Results: There were a total of 100 patients. Group A patients had median (IQR) pain scores of 4.5 (1), 3 (2) and 2 (1) as compared to group B pain scores of 4 (2), 2 (1) and 0 (1) at 24 hours of surgery (p-value=0.009), at discharge (p-value<0.001) and after 1 month of surgery (p-value<0.001), respectively. A comparatively higher decline in the postoperative pain scores was evaluated in group B from the first day of operation till one month post-surgery follow up. (p-value<0.001).

Conclusion: The use of 5mm umbilical port, supersedes 10mm umbilical port in having decreased frequency of postoperative pain after laparoscopic cholecystectomy.