Background: Laparoscopic cholecystestectomy(LC) has become the preferred treatment for managing cholelithiasis of the gallbladder. Generally, four-portal technique is used to performe LC. The advantages of LC is due to the minimal invasiveness of the procedure. For this reason, the minimal invasiveness has been one of the main goals of laparoscopic procedures and having fewer portals would promote the purpose of laparoscopic surgery. In this report, we tried to determine whether or not three-portal technique could be chosen as an alternative to four-portal technique for the performance of LC.

Methods: Two surgeons, each of them had already performed more than one hundred cases of LC, have performed 283 cases of LC to the all cases of gallbladder disease at Kyunghee University Hospital from January 1997 to June 1998. one sugeon used three-portal technique (165 cases) and another four- portal technique (118 cases). The operation time, conversion rates, postoperative hospital stay, and postoperative complications were evaluated with the outcome of two techniques.

Results: The 6 cases (3.6%) of three-portal technique were converted to four-portal technique. Between the two techniques, there were no significant differences in operation time, conversion rate, postoperative hospital stay, and postoperative complication, but the three-portal technique might have more advantages than the four-portal technique: better cosmesis, because of fewer scars and lower cost, since one less assistant and disposable trocar is required.

Conclusions: The three-portal technique may have similar clinical results to those of the four-portal technique with more economical and cosmetic advantages, but requires more skillful techniques. The three-portal technique can easily convert to the four-portal technique. The authors would like to recommend the three-portal technique for qualified laparoscopic surgeons as a standard technique to perform LC.

Keywords: Three-portal technique, Four-portal technique, Laparoscopic cholecystectomy