经脐单孔腹腔镜胆囊切除术22例报告

Transumbilical single-port laparoscopic cholecystectomy: 22 cases report

目的:总结经脐单孔腹腔镜胆囊切除术的可行性和应用前景。方法:2009年10月至2010年6月,上海市嘉定区中心医院应用普通腹腔镜器械行经脐单孔腹腔镜胆囊切除术22例(单孔组),与同期常规腹腔镜胆囊切除术22例(四孔组)进行分析和比较。结果:手术时间:单孔组(52.3±8.1)min,四孔组(47.4±5.3)min,P<0.05。术中出血量:单孔组(11.9±1.3)mL,四孔组(11.5±1.2)mL,P>0.05;术后住院时间:单孔组(3.5±0.7)d,四孔组(3.4±0.6)d,P>0.05;术后疼痛评分采用Prince-Henry 5级评分法:单孔组(3.2±0.7),四孔组(3.4±0.7),P>0.05。两组差异除平均手术时间外,其他均无统计学意义。无并发症发生,脐部瘢痕隐蔽。结论:经脐单孔腹腔镜胆囊切除术操作难度大;有技术条件的医院,可在慎重选择病例的基础上开展。

Objective To summarize the feasibility of transumbilical single-port laparoscopic cholecystectomy（TUSPLC）.Methods From Oct 2009 to Jun 2010,the Central Hospital of Jiading District,Shanghai,by using the ordinary laparoscopic instruments,performed TUSPLC in 22 cases,and conventional laparoscopic cholecystectomy in 22 cases;the two methods were compared.Results The operation time： single-hole group（52.3±8.1） min,4-hole group（47.4±5.3） min,P0.05.bleeding： single-hole group（11.9±1.3） mL,4-hole group（11.5±1.2） mL,P0.05;Postoperative hospital stay： single-hole group（3.5±0.7） d,4-hole group（3.4±0.6） d,P0.05.Postoperative pain score by Prince-Henry 5 class score method： single-hole group（3.2±0.7）,4-hole group（3.4±0.7）,P0.05.The difference in operative time in the 2 groups was statistically significant,while in other respects they were not.There were no complications,and the umbilical scars were not outstanding in both groups.Conclusions Since TUSPLC is more difficult to perform,surgeons can choose it in patients carefully selected in qualified hospitals.