Muhammad Danish Muneeb, Mirza Agha Naushad Baig.
Postoperative Pain After Gallbladder Retrieval from Umbilical and Epigastric Ports in Laparoscopic Cholecystectomy: a Randomized Controlled Trial.
J Dow Uni Health Sci Jan ;13(3):138-42.

Objective: To compare the postoperative pain after gallbladder removal from umbilical port site versus epigastric port site, after four ports laparoscopic cholecystectomy.Methods: A randomized controlled trial was performed during 1-year period from January 2017 till January 2018, at a private hospital setup. Both male and female patients, with age group 18 years and above were considered, who were planned for four ports laparoscopic cholecystectomy after typical cholelithiasis. Those with polyps, mucocele or empyema in gallbladder or perforated gallbladder requiring emergency surgery were excluded from the study. Patients were equally assigned into two groups based on the removal region, with 65 in group A (umbilical region) and 65 in group B (epigastric region). Postoperative pain was measured using Numerical Analogue Scale (NAS) at 3 points of the study: (1) Day one, (2) at the time of discharge (3) At the time of follow up after 1 month.Results: From 130 patients, group A showed median pain (IQR) of 5 (4-5.5), 4 (3-4) and 2 (2-3) when compared with group B median pain (IQR) of 4 (3-4), 2 (2-3) and 1 (0.5-1) one day after the procedure (p-value=0.001), at the time of release from the hospital (p-value<0.001) and one month post-surgery (p-value<0.001) respectively. Conclusion: Epigastric port site removal of gallbladder produced less postoperative pain after removal of gallbladder as compared to the umbilical port site. Therefore, it is suggested to perform gallbladder removal surgery using epigastric port site

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