经脐入路与传统腹腔镜胆囊切除术的比较

Comparison of transumbilical and conventional laparoscopic cholecystectomy

目的评价经脐入路腹腔镜胆囊切除术的安全性、可行性及潜在的优势。方法 60例胆囊疾患患者分别行经脐入路(TUES组,n=30)和传统腹腔镜胆囊切除术(LC组,n=30),比较两组手术时间、术中出血量、手术中转率、并发症、术后疼痛评分、手术美容满意度和总费用。结果 60例手术均成功。TUES组3例转LC,LC组1例中转开腹。无手术并发症发生。LC组手术时间较TUES组缩短(P<0.05),TUES组美容满意度明显优于LC组(P<0.05),其他指标差异均无统计学意义(P>0.05)。结论 TUES胆囊切除术安全可行,能够取得和LC相同的临床结果,并且美容效果更好,患者满意度更高。

Objective To evaluate the efficacy, safety and feasibility of transumbilical laparoscopic cholecystectomy in comparison of conventional modality. Methods Sixty patients underwent transumbilical laparoscopic cholecystectomy （TUES group, n = 30 ） or conventional laparoscopic cholecystectomy （LC group, n = 30）. Operation time, blood loss, length of hospital stay, surgical complications, total costs and cosmetic results were compared between two groups. Results All operations were successful without major surgical complications in both groups. There were no significant differences in blood loss, complications rates, length of hospital stay or the total costs. The patients undergoing transumbilical cholecystectomy showed better cosmetic results （P 〈 0.05 ） and longer operative time （P 〈 0.05 ）. Conclusion Transumbilical laparoscopic cholecystectomy is a safe and feasible surgical modality, however, multicenter randomized clinical trials are necessary to further elucidate the safety and efficiency of this new technique.