Abstract
Background: Gall bladder retrieval in laparoscopic cholecystectomy, affects postoperative port site pain, keloids, hypertrophic scars, and trocar site hernia (TSH).
Methods: This retrospective study holds significant implications for laparoscopic cholecystectomy. Its objective is to assess the rate of postoperative 6-month keloid or hypertrophic scar, pain, and other complications, primarily TSH, after GB retrieval from the right lumbar port using the approach 5-5-5-10. The study includes records and videos of the operations of eligible patients who underwent laparoscopic cholecystectomy at the Aswan University Hospital.
Results: The analysis of this study, which included 977 patients, revealed several key findings. Most of the participants were females, representing 93.1%. The mean age was 44.3±11.9 years, the mean ± SD. Operative time was 104.2±32.4 minutes, and the median (IQR) was 101.0 (54.0) minutes. The mean postoperative pain using VAS was 2.5±1.1 with a median (IQR) of 2.0(2). The average follow-up period was 28.5 ± 12 months. The 6-month mean score of cosmetic appearance using the 5-Likert scale was 3.9±1 with a median (IQR) of 4.0(2). Only 28 cases (2.9%) experienced Keloid: 13 (1.3%) were epigastric, 10 (1.0%) umbilical, and 5 (0.5%) were in all ports' sites. Also, another 20 (2%) had hypertrophic scar at the right lumbar port site. None has experienced TSH.
Conclusion: Extracting the gall bladder through the right lumbar port is a preferable option, considering factors such as the resulting appearance of the scar and the incidence of TSH. We strongly recommend the 5-5-5-10 approach for gall bladder retrieval.