Hawanga GD, Zhang XL, Li ZX, Li MX, Pan J, Wang KM, Qian DH. Clinical outcomes of single-port, modified two-port, and three-port laparoscopic cholecystectomy: A comparative retrospective cohort study. World J Gastrointest Endosc 2026; 18(4): 117389 [DOI: 10.4253/wjge.v18.i4.117389]
Corresponding Author of This Article
Dao-Hai Qian, MD, PhD, Associate Chief Physician, Associate Professor, Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, No. 24 Yinhu South Road, Jinghu District, Wuhu 241001, Anhui Province, China. 20161106@wnmc.edu.cn
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Gastroenterology & Hepatology
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Retrospective Cohort Study
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Apr 16, 2026 (publication date) through Apr 16, 2026
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World Journal of Gastrointestinal Endoscopy
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1948-5190
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Hawanga GD, Zhang XL, Li ZX, Li MX, Pan J, Wang KM, Qian DH. Clinical outcomes of single-port, modified two-port, and three-port laparoscopic cholecystectomy: A comparative retrospective cohort study. World J Gastrointest Endosc 2026; 18(4): 117389 [DOI: 10.4253/wjge.v18.i4.117389]
World J Gastrointest Endosc. Apr 16, 2026; 18(4): 117389 Published online Apr 16, 2026. doi: 10.4253/wjge.v18.i4.117389
Clinical outcomes of single-port, modified two-port, and three-port laparoscopic cholecystectomy: A comparative retrospective cohort study
Gabriel Dickson Hawanga, Xiu-Lei Zhang, Zhao-Xing Li, Mao-Xin Li, Jun Pan, Kai-Ming Wang, Dao-Hai Qian
Gabriel Dickson Hawanga, Xiu-Lei Zhang, Zhao-Xing Li, Mao-Xin Li, Jun Pan, Kai-Ming Wang, Dao-Hai Qian, Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui Province, China
Author contributions: Hawanga GD wrote the main manuscript text; Zhang XL, Li ZX, Li MX, Pan J, Wang KM, and Qian DH prepared the figures and tables. All authors reviewed the manuscript.
Institutional review board statement: This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Yijishan Hospital of Wannan Medical College (approval No. 2024-70).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available due to institutional regulations and patient privacy considerations but are available from the corresponding author upon reasonable request and with approval from the Ethics Committee of Yijishan Hospital of Wannan Medical College.
Corresponding author: Dao-Hai Qian, MD, PhD, Associate Chief Physician, Associate Professor, Department of Hepatobiliary Surgery, Yijishan Hospital of Wannan Medical College, No. 24 Yinhu South Road, Jinghu District, Wuhu 241001, Anhui Province, China. 20161106@wnmc.edu.cn
Received: December 8, 2025 Revised: December 25, 2025 Accepted: January 28, 2026 Published online: April 16, 2026 Processing time: 128 Days and 19.2 Hours
Abstract
BACKGROUND
While laparoscopic cholecystectomy (LC) is the gold standard procedure for symptomatic gallbladder pathologies, the pursuit of minimizing invasiveness and improving cosmetic outcomes has led to techniques like single-port (SP) and modified two-port (MTP) LC. However, their comparative efficacy against the conventional three-port (TP) approach, particularly the novel MTP technique, requires further validation.
AIM
To compare the cosmetic, operative, and clinical outcomes of MTP, SP, and TP LC.
METHODS
This retrospective cohort study included 142 patients with symptomatic gallbladder disease who underwent MTP, SP, or TP LC from January 2024 to January 2025. All procedures were performed by a single experienced surgeon. The primary outcome was cosmetic satisfaction at one month. Secondary outcomes included operative time, intraoperative blood loss, hospital stay, and postoperative complications. Multivariable analyses were performed following adjustment for age, sex, and body mass index, with a Bonferroni correction applied.
RESULTS
All procedures were completed laparoscopically. MTP LC demonstrated the shortest operative time (52.5 ± 19.5 minutes), which was significantly shorter than that of SP LC (103.1 ± 34.9 minutes, P = 0.009) and comparable to that of TP LC (55.2 ± 23.0 minutes, P = 0.566). MTP LC also yielded the shortest hospital stay (1.2 ± 0.5 days). Cosmetic outcomes were superior for MTP and SP LC vs TP LC(P < 0.05). Blood loss was minimal (< 10 mL) in all groups. One case of postoperative infection occurred in the SP LC group. After adjustment for confounding factors, MTP LC maintained a shorter operative time vs SP LC (β = -48.2, P < 0.001) and exhibited comparable safety to TP LC (odds ratio: 1.02, P = 0.31).
CONCLUSION
MTP LC balances the cosmetic benefit of SP LC with the efficiency and safety of TP technique, though its generalizability requires prospective validation.
Core Tip: This retrospective cohort study compares modified two-port (MTP), single-port (SP), and three-port (TP) laparoscopic cholecystectomy (LC) to determine the optimal balance between invasiveness, efficiency, safety, and cosmetic outcomes. MTP LC demonstrated the shortest operative and recovery times, no complications, and excellent scar concealment, outperforming SP and TP LC. While SP LC achieved similar cosmetic results, it was limited by prolonged operative time and higher infection risk. These findings highlight MTP LC as a preferred, patient-centered approach for symptomatic gallbladder disease.
