Surgical Outcomes of Gallbladder Retrieval via Different Ports in Laparoscopic Cholecystectomy.

Abstract

Background: An important step during laparoscopic cholecystectomy that has a proven effect on postoperative morbidity and outcomes is the site of gallbladder retrieval, which is either through the umbilical or epigastric port. Currently, no guidelines recommend the superiority of one port over the other, and it is mainly based on the surgeon's preference. This study aimed to address the outcomes and complications of gallbladder retrieval through the epigastric port in comparison with the umbilical port and to identify the associated risk factors.

Methods: A retrospective review of 658 patients who underwent laparoscopic cholecystectomy between 2020 and 2021 was conducted. Patient demographics, preoperative workups, intraoperative findings, and postoperative outcomes were compared between retrieval via the epigastric and umbilical ports.

Results: Gallbladder retrieval occurred through the epigastric port in 441 patients and through the umbilical port in 217 patients. The epigastric group had a greater mean age (44.2 ± 14.90 vs 41.3 ± 14.47 years; P = .0109), and most the study population was female (7.2%). Intraoperative duration and bleeding were comparable, but fascial plane extension was more common in the umbilical group (6.9%; P = .0179). Port site hernias occurred in 1.8% of patients, all of whom were females (P = .0222), and were associated with older age, higher body mass index (BMI), and gallbladder needle decompression (P = .0356). The length of hospital stay was similar across both groups.

Conclusion: Epigastric port retrieval during laparoscopic cholecystectomy offers comparable intraoperative outcomes to those of umbilical retrieval. However, hernia risk, which is linked to specific factors, warrants further research to improve outcomes.