经脐单孔腹腔镜下胆囊切除术应用体会（附80例报告）

Transumbifical single incision laparoscopic cholecystectomy for gallbladder benign diseases： A report of 80 cases

目的了解胆囊良性疾病行经脐单孔腹腔镜下胆囊切除术（SILC）的学习曲线。方法80例胆囊良性疾病患者按常规手术步骤行SILC，记录并分析围手术期相关资料，以手术时间定义学习曲线。结果80例患者成功接受SILC，其中胆囊结石56例，胆固醇性息肉16例，腺瘤性息肉3例，胆囊腺肌症1例和胆囊复杂病例4例，无患者中转为传统腹腔镜下胆囊切除术或开放手术。平均手术时间为（46．9±14．6）min，平均术后住院时间为（1．8±1．3）d。无围手术期并发症。学习曲线显示有经验的腹腔镜医师需要积累40例左右的手术经验才能度过学习期。结论SILC对于有经验的外科医生是一个简单而安全的手术，对于患者具有疼痛更轻微、更低的戳孔并发症、更好的美观度及更快的恢复等优点。SILC可能会成为良性胆囊疾病的另一种手术选择。

Objective To investigate a single surgeon＇ s learning curve of transumbilical single incision laparoscopic cholecystectomy （SILC）in the treatment of gallbladder benign diseases. Methods Eighty patients with gallbladder benign disease accepted SILC operated by a single experienced laparoscopie surgeon. The operation was performed following the routine LC procedure. The perioperative data were recorded and the learning curve was defined by the operation time. Results Eighty patients accepted SILC successfully,including 56 cases of gallbladder stones, 16 cases of cholesterol polyps, 3 cases of adenomatous polyp, 1 case of adenomyomatosis and 4 cases of complex diseases. No patients were converted to con- vcntional LC or open surgery. The average operative duration was 46.9 ± 14.6 min. The average postoperative hospital stay was 1.8±1.3 days. There was no perioperative complication. The learning curve of the SILC procedures indicated the first 40 cases as a learning phase for an experienced laparoscopic surgeon. Conclusion SILC is an easy and safe procedure for experienced laparoscopic surgeons. There are significant benefits as milder pain,lower incidence of port - related complications, better cosmetology and faster recovery. SILC may become another option for the treatment of gallbladder benign diseases.