经脐单孔腹腔镜胆囊切除术可行性分析(附48例报告)

A feasibility analysis of trans-umbilical single-port laparoscopic cholecystectomy: Report of 48 cases

目的探讨经脐单孔腹腔镜胆囊切除术(TSPALC)的可行性。方法将我院2009～2011年期间行TSPALC的48例患者作为观察组(TSPALC组),并将同期施行LC术的383例中随机选取36例患者作为对照组(传统LC组),比较两组的手术时间、术中副损伤、术后疼痛评估、术后肠功能恢复、术后并发症以及住院时间,并予以比较分析。结果观察组与对照组平均手术时间分别为(49±12)、(40±10)min,两组差异无统计学意义。观察组和对照组术后肠功能恢复时间及术后住院时间分别为(18±10)、(30±11)h和(2.0±0.4)、(5.0±0.6)d,观察组明显短于对照组(P<0.05)。观察组患者术后即刻及术后3、6、12、24、48 h视觉模拟评分(VAS评分)明显低于对照组(P<0.05)。两组术中均无副损伤,术后均未发生并发症。结论 TSPALC与传统LC同样安全可行,且TSPALC较传统LC具有腹部无明显手术瘢痕及术后疼痛更轻、恢复快等优点。

Objective To explore the feasibity of transumbilical single-port laparoscopic cholecystectomy.Methods During the period of February 2009 to January 2011 48 patients with gallbladder diseases received transumbilical single-port laparoscopic cholecystectomy（TSPALC）,and 36 patients were treated with the conventional laparoscopic cholecystectomy（LC）.Clinical effects were analyzed for the two groups.Results All the operations were successfully performed,without postoperative bleeding or biliary leakage.For the TSPALC group,the mean time of operation was（49±12）min,as compared to the（40±10） min for the LC group（P0.05）.For the TSPALC group,postoperative intestinal function recovery time was（18±10）h,the hospitalization time was（2.0±0.4）d,compared to the（30±11）h and（5.0±0.6）d,respectively,for the LC group（P0.05）.The VAS score for the TSPALC group was significantly lower than that for the LC group（P0.05）.Conclusions TSPALC is a safe and feasibleprocedure,with a significant benefit of no visible scar on the abdominal wall,in addition to less severe post-operative pain and quicker recovery than with LC.