经脐单孔腹腔镜胆囊切除术36例

Transumbilical Single Port Laparoscopic Cholecystectomy:Report of 36 Cases

目的探讨经脐进行单孔腹腔镜胆囊切除术的可行性及临床价值。方法 2009年5月～2010年1月,对36例慢性胆囊炎经脐部施行单孔腹腔镜胆囊切除术,手术使用多孔道套管和可弯曲的加长腹腔镜操作器械。结果全部手术均获成功,无中转常规腹腔镜手术或开腹手术。手术显露良好,器械操作相互无影响,手术过程顺利,术中出血少(<3ml),手术时间(51±10)min(40～70min),均未放置引流管。术后无出血、胆管损伤等并发症发生。术后1～2d出院。36例随访1～3个月,无腹痛等不适症状,腹壁无可见手术瘢痕。结论经脐进行单孔腹腔镜胆囊切除术安全可行,具微创及美容优势,使用多孔道套管和可弯曲的加长腹腔镜操作器械可以降低手术难度,具有临床推广价值。

Objective To investigate the feasibility and clinical value of transumbilical laparoscopic cholecystectomy （LC） by using a single trocar. Methods During May 2009 to January 2010,single-port LC was performed on 36 patients with chronic cholecystitis. Multi-channel port and flexible instruments were used during the operation. Results The operation was successfully completed without conversion to routine laparoscopic surgery or open surgery in all of the cases. We achieved a good vision during the operation. The mean operation time was （51±10） minutes （ranged from 40 to 70 minutes）,during which the blood loss was less than 3 ml in all the cases. No patient needed postoperative drainage after the surgery. None of them had hemorrhage or biliary injury. The patients were discharged from hospital in 1 to 2 days afterwards. Thirty-six patients were followed up for 1 to 3 months,during which no patients had abdominal pain or other complaints. No surgical scars could be observed on the abdomen. ConclusionsTransumbilical single port LC is feasible,safe and minimally invasive with good cosmetic outcomes. Multi-channel port and flexible instruments are useful to decrease the difficulty level of the procedure.