Prospective Observational Study of Post-Operative Port-Site Pain After Gall Bladder Retrieval from Umbilicalvs Epigastric in Laparoscopic Cholecystectomy
Authors
Dr. Mohd Shaad ShaikhFiles
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Journal
Published in Vol. 67 No. 4 (2025) of Bombay Hospital Journal.
Bombay Hospital Journal (BHJ) is a peer-reviewed quarterly published Print and Online journal. It is an official Journal of Bombay Hospital institute of medical sciences. The aim of BHJ is to improve medical care by publishing sound scientific articles (both research and practice papers) and focusing on topics that are of great importance to its readership.
Editor-in-Chief- Dr Satish Vasant Khadilkar
About the JournalAbstract
Background: Laparoscopic cholecystectomy is the standard surgical treatment for benign gallbladder disease. Although minimally
invasive, postoperative port-site pain remains a common concern and may influence patient recovery. Gallbladder retrieval is a
critical terminal step of the procedure and can be performed through either the umbilical or epigastric port; however, the optimal
retrieval site with respect to postoperative pain remains controversial.
Objectives: To compare postoperative port-site pain following gallbladder retrieval through the umbilical versus epigastric port in
patients undergoing elective four-port laparoscopic cholecystectomy, and to evaluate secondary outcomes including retrieval time,
surgical site infection, and length of hospital stay.
Methods: This prospective observational study was conducted over 18 months at a tertiary care center. Eighty adult patients
undergoing elective laparoscopic cholecystectomy were enrolled and divided into two groups based on the port used for gallbladder
extraction: umbilical port (n = 40) and epigastric port (n = 40). Postoperative pain was assessed using the visual analogue scale at
1, 6, 12, 24, and 36 hours after surgery. Demographic variables, gallbladder extraction time, surgical site infection, and duration of
hospital stay were also recorded and analyzed.
Results: Baseline demographic and operative characteristics were comparable between the two groups. Patients in the umbilical
port group demonstrated significantly lower postoperative pain scores at all assessed time intervals compared to the epigastric port
group (p < 0.05). No statistically significant difference was observed between the groups in gallbladder extraction time, incidence of
surgical site infection, or length of hospital stay.
Conclusion: Gallbladder retrieval through the umbilical port is associated with significantly reduced postoperative port-site pain
without increasing operative time, infection rates, or hospital stay. The umbilical port may therefore be preferred for gallbladder
extraction during elective laparoscopic cholecystectomy to improve postoperative patient comfort.
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