Abstract: Objective To evaluate the clinical efficacy and safety of three-port transumbilical endoscopic cholecystectomy
performed using conventional laparoscopic instruments. Methods Thirty-two patients undergoing three-port transumbilical
endoscopic cholecystectomy using conventional laparoscopic instruments (group A) with 3 ports around the umbilicus were
compared with 96 patients (group B) receiving the conventional 4-port routine endoscopic cholecystectomy. Results All the
procedures were successfully completed without conversion to open laparotomy. In group A, the procedures were completed
smoothly in 30 cases while 2 cases required another port (5 mm) punctured below the xyphoid due to severe adhesion around
the cyst. The median operating time was 39.7±5.2 min in group A, significantly longer than that in group B (25.3±3.3 min, P<
0.001), but the patients in group A obtained better cosmetic results (P<0.001); the median blood loss, recovery time of
postoperative intestine function, length of postoperative hospital stay, and the rate of use of postoperative painkillers were
comparable between the two groups. Bile leakage or other postoperative complications occurred in none of cases in the two
groups. Conclusion In cases without severe adhesion around the cyct, three-port transumbilical endoscopic cholecystectomy
using conventional laparoscopic instruments is a safe and feasible alternative to routine endoscopic cholecystectomy with
better cosmtic results.