Impact of Specimen Extraction Site and Gallstone Size on Early Postoperative Pain Following Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Study
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.35, sa.1, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 1
- Basım Tarihi: 2024
- Doi Numarası: 10.1097/sle.0000000000001343
- Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Anahtar Kelimeler: laparoscopic cholecystectomy, postoperative pain, trocar site, gallstone size, pain management
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Laparoscopic cholecystectomy (LC) is widely performed with generally favorable outcomes, but postoperative pain remains a significant issue, influenced by various factors including the specimen extraction site and gallstone size. Methods: A prospective randomized controlled study was conducted on 100 patients undergoing LC. Participants were randomized to have the specimen removed through either the epigastric or umbilical trocar. Postoperative pain was assessed using the visual analog scale (VAS) on postoperative days 1, 3, and 7. Statistical analyses were performed to evaluate the impact of trocar site and gallstone size on pain levels. Results: Patients whose specimens were extracted through the umbilical trocar experienced significantly less pain on postoperative days 1 and 3 (P=0.006 and 0.014, respectively) than those with epigastric trocar extraction. In addition, patients with gallstones larger than 10 mm reported higher pain levels on day 3 (P=0.001) irrespective of the extraction site. Conclusions: The umbilical trocar site for specimen extraction and smaller gallstone size is associated with reduced early postoperative pain following LC. These findings suggest the importance of considering extraction site and gallstone size in managing postoperative pain in LC patients.