Epigastric Port Site Complications and Affecting Factors\rused for Gallbladder Specimen Extraction in Laparoscopic\rcholecystectomy

Abstract

Introduction: Complications occur at the port site where the specimen is excised after laparoscopic cholecystectomy\r(LC). In this study, it was aimed to investigate port-site complications.\rMaterials and Methods: The results of patients who underwent LC surgery in our center between January\r01, 2018, and December 31, 2020, were retrospectively analyzed. Patients who were decided to have open\rsurgery and reside abroad were excluded from the study. Pre-operative, intraoperative, and post-operative\rfactors of all patients, which were considered to impact the development of complications, were noted down.\rResults: A total of 357 patients were included in the study. A total of 24 (6.7%) patients had epigastric trocar\rsite infection (EPSI). It was found out that trocar site hematoma was a risk factor causing a 39.37-fold\rincrease in the development of EPSI (<0.001) (95% confidence interval =10.69–144.97), while dilatation at\rthe trocar site was a risk factor causing a 3.1-fold increase (p=0.027) (95% confidence interval =1.14–8.48).\rTen patients had epigastric trocar insertion site hernia (EPSH). As a result of the multivariant analysis, it was\rdetermined that the development of EPSI caused the development of EPSH 27.59 times more (95% confidence\rinterval =5.92–128.7) (p<0.001), while the accompanying additional laparoscopic procedure caused\rthe development of EPSH 6.2 times more (95% confidence interval =6.2–1.17) (p=0.032).\rConclusion: Preventing the occurrence of hematoma in the epigastric trocar insertion site, where the specimen\ris excised after LC surgery, reduces the risk of EPSI, and indirectly reduces the incidence of EPSH.\rMoreover, we recommend careful follow-up for EPSH in patients who underwent additional laparoscopic\rsurgery during LC.