Comparative Evaluation of Surgical Outcomes Utilizing Umbilical versus Epigastric Access for Specimen Retrieval in Laparoscopic Cholecystectomy

Introductions: Laparoscopic cholecystectomy represents the established therapeutic modality for symptomatic cholelithiasis. Postoperative analgesia requirements and the duration of postoperative hospitalization are significantly influenced by the extent of pain experienced by patients. During this procedure, the gallbladder (GB) can be extracted via either the umbilical or the epigastric port site. Excessive manipulation during GB retrieval is a potential contributor to postoperative pain. Methods: A retrospective, observational study was conducted on 120 patients with symptomatic gallstone disease requiring laparoscopic cholecystectomy between January 2024 and December 2024. Exclusion criteria encompassed patients with perforated GB necessitating emergency intervention, those with GB carcinoma requiring elective laparoscopic radical cholecystectomy, and cases where laparoscopic surgery was converted to open cholecystectomy. Participants were randomly assigned to two equal groups (n=60 each): Group A, where GB retrieval was performed through the epigastric port, and Group B, where GB retrieval was performed through the umbilical port. The primary and secondary outcomes assessed included intraoperative duration, postoperative pain intensity (measured using a standardized pain scale), incidence of wound infection, and the development of port site hernia. Results: Statistical analysis revealed no significant inter-group differences in intraoperative time, the incidence of wound infection, or the development of port site hernia. However, patients in Group B, where the GB was retrieved through the umbilical port, reported significantly lower postoperative pain scores compared to Group A. Conclusion: While the choice of umbilical versus epigastric port for GB retrieval in laparoscopic cholecystectomy does not significantly impact intraoperative duration, wound infection rates, or port site hernia formation, umbilical port retrieval is associated with a statistically significant reduction in postoperative pain.