三孔法腹腔镜胆囊切除术的体会及应用价值

Application of three-hole method in laparoscopic cholecystectomy

目的:探讨三孔法腹腔镜胆囊切除术的应用条件及价值。方法:总结74例三孔法LC的临床资料,对其应用条件和价值进行分析。结果:74例术后均痊愈出院,其中50例用三孔法完成,术中改行四孔法LC23例,中转开腹1例。三孔法LC完成的50例疼痛反应,肠功能恢复时间与住院时间与四孔法LC无明显差别。手术难度增加,平均手术时间延长。全组无胆管损伤,胆漏、出血等严重并发症。结论:三孔法LC在四孔法LC基础上减少了创伤,也增加了手术难度,手术时间和并发症发生的机率,须结合手术医师和病情决定是否实施。

Objective:To evaluate the value of three-hole method in laparoscopic cholecystectomy. Methods: Clinical records of 74 patients who underwent laparoscoic cholecystectomy using three-hole method in our hospital were analyzed and the indications of this technique were discussed. Results:74 cases were cured. Among them,50 patients were treated by three -hole method. 23 cases were converted to four -hole method and 1 to laparotomy. There were no significant difference between three and four-hole methods in ache reaction, the average recovery time of bowel movement and hospitalization time, but the former had more difficulty in operation and prolonged operative time.There were no serious complications, such as bile duct injury, bile leakage and bleeding et al. conclusion: Although three-hole method is less traumatic compared with four- hole method.it has some disadvantages and potential complications. There fore, it should be selectively carried out according to the skill level of the operator and the concrete condition of the patient.