经脐单孔腹腔镜胆囊切除术的初步经验

Preliminary experience of transumbilical single-incision laparoscopic cholecystectomy

目的：总结经脐单孔腹腔镜胆囊切除术临床应用的初步经验。方法：为40例胆囊良性疾病患者行胆囊切除术，应用普通腹腔镜器械及改良 Trocar经脐单孔完成手术。结果：37例成功完成经脐单孔腹腔镜胆囊切除术，3例转为3孔法腹腔镜胆囊切除术．无一例中转开腹。手术时间20～45rain，平均33min。术后恢复顺利，无出血、胆漏等并发症发生，平均住院4d。术后随访3个月，无并发症发生，切口美容效果满意。结论：用改良Trocar及普通器械行经脐单孔腹腔镜胆囊切除术安全可行，便于推广。由于操作难度较大，需选择应用。

Objective：The purpose of this study is to summarize the preliminary experience of laparoscopic cholecystectomy through a transumbilieal single incision. Methods ： Transumbilical single-incision laparoscopic choleeystectomy was performed for 40 consecutive patients with gallbladder benign diseases. The procedures were completed with modified Troears and ordinary instrumenta- tion. The patients were followed up postoperatively for at least 3 months. Results：Of the 40 patients,37 underwent transumbilical singleincision laparoseopie eholecystectomy and 3 cases were convened to the standard three-port laparoseopic technique. No conversion to laparotomy occurred. The mean operative time was 33rain （range,20-45min）. The postoperative recovery was uneventful, no major complications occurred,including hemorrhage and bile leakage. The mean hospital stay was 4d. The patients were followed up postoperatively for at least 3 months. The cosmetic effect of incision was satisfactory without any complications. Conclusions： Transumbilieal singleincision laparoseopic cholecystectomy using modified Trocar and ordinary instrumentation is safe, feasible and easy to be generalized. However, it should be performed in suitable patients due to the complex technical requirements.