Elective transumbilical compared with standard laparoscopic cholecystectomy

Objective: To compare the transumbilical technique of laparoscopic cholecys tectomy with standard laparoscopic cholecystectomy.j: Design: Randomised open study. Setting: Teaching hospital, Italy. Subjects: 90 patients who required elective cholecystectomy under general a naesthesia. Interventions: Standard laparoscopic cholecystectomy through 4 ports or tra nsumbilical cholecystectomy through 2 ports. Main outcome measures: Amount of pain and analgesia, cost: side effects, an d cosmesis. Results: 25 patients were excluded from analysis (8 in the standard group b ecause relevant data were not recorded; and 17 in the transumbilical group in 4 of whom relevant data were not recorded, and 13 for technical reasons) . 32 patients who had standard, and 25 who had transumbilical cholecystecto my had operative cholangiograms. There were no complications, no side effec ts, and no conversions to open cholecystectomy. Those who had transumbilica l cholecystectomy had significantly lower pain scores (p < 0.05) and requir ed significantly less analgesia during the first 24 hours (p < 0.05) than t hose who had standard laparoscopic cholecystectomy. Conclusion: Once the learning curve has been completed, transumbilical chol ecystectomy is possible without some of difficulties associated with standa rd laparoscopic cholecystectomy.