Comparative Evaluation of Gall Bladder Extraction via Epigastric & Umbilical Ports during Laparoscopic Cholecystectomy: A Prospective Randomized Study

Abstract

Introduction: Postoperative port-site pain is a major concern after laparoscopic cholecystectomy (LC). The epigastric or umbilical port used for gall bladder extraction may influence wound pain due to tissue trauma, but evidence remains inconclusive.

Aim & Objective: To compare postoperative port-site pain, ease of gall bladder retrieval, and extraction time between epigastric and umbilical port extraction during laparoscopic cholecystectomy.

Material & Methods: A prospective randomized controlled trial was conducted over 24 months in a tertiary-level surgical unit. Seventy-two eligible patients were randomized into two equal arms: Group I (epigastric port extraction, n = 36) and Group II (umbilical port extraction, n = 36). Port-site pain was quantified using the Visual Analogue Scale (VAS) at 6, 12, 24, and 36 hours after surgery. Ease of retrieval was documented by the primary surgeon on the same VAS, and total extraction time was recorded in seconds.

Results: Patients in the umbilical port group demonstrated significantly lower mean port-site pain scores (7.20 ± 0.80) compared with the epigastric group (7.74 ± 0.61), with P = 0.0019. Surgeon-rated ease of retrieval was also significantly superior in the umbilical group (P = 0.0015). Conversely, mean extraction time was substantially shorter in the epigastric cohort (30.12 ± 10.95 s vs. 52.40 ± 14.87 s; P < 0.0001). No port-site infection or hernia was recorded in either group during the six-week follow-up.

Conclusion: The umbilical port is associated with meaningfully reduced postoperative wound pain and superior ease of gall bladder retrieval when compared with the epigastric port. Despite requiring more extraction time, the umbilical approach is recommended as the preferred site for GB removal during conventional four-port LC.

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