Elective transumbilical compared with standard laparoscopic cholecystectomy

Objective: To compare the transumbilical technique of laparoscopic cholecystectomy with standard laparoscopic cholecystectomy.j: Design: Randomised open study. Setting: Teaching hospital, Italy. Subjects: 90 patients who required elective cholecystectomy under general anaesthesia. Interventions: Standard laparoscopic cholecystectomy through 4 ports or transumbilical cholecystectomy through 2 ports. Main outcome measures: Amount of pain and analgesia, cost: side effects, and cosmesis. Results: 25 patients were excluded from analysis (8 in the standard group because 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 cholecystectomy had operative cholangiograms. There were no complications, no side effects, and no conversions to open cholecystectomy. Those who had transumbilical cholecystectomy had significantly lower pain scores (p < 0.05) and required significantly less analgesia during the first 24 hours (p < 0.05) than those who had standard laparoscopic cholecystectomy. Conclusion: Once the learning curve has been completed, transumbilical cholecystectomy is possible without some of difficulties associated with standard laparoscopic cholecystectomy.