Purpose: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic cholelithiasis and acute cholecystitis. There are various methods that are frequently performed depending on the surgeon's preference: the three-port, four-port or two-port methods. In this study, we compared the clinical characteristics of the three-port method and those of the four-port method, and we estimate the usefulness of the three-port method. Methods: We reviewed the medical record of 346 patients who underwent laparoscopic cholecystectomy with the three-port method (n=255) or the four-port method (n=91) from January 2002 to October 2006. We compared many variables between the two methods. Results: There was no statistical difference between the three and four-port groups in terms of the operation time, the conversion rate, the length of the postoperative hospital stay and the postoperative complications. Yet the patients who underwent the three-port method required less additional injections of analgesia than those patients who underwent the four-port method (p=0.025). Conclusion: The three-port method is as safe as the standard four-port method when the former is performed by expert hands. The procedure also offers considerable advantages over the traditional four-port method for reducing the analgesia requirement and achieveing cosmetic advantages.

Keywords: Laparoscopic cholecystectomy, Three-port method, Four-port method