经脐单孔腹腔镜胆囊切除术临床探讨

The clinical investigation on the pucker umbilical laparoscopic cholecystectomy

目的:探讨经脐单孔腹腔镜胆囊切除术(TUSPLC)的临床应用。方法:回顾性分析2009年8月—2012年3月收治的42例胆囊结石或胆囊息肉患者的临床资料,19例行TUSPLC为观察组,23例行常规三孔腹腔镜胆囊切除术(LC)为对照组。比较两组手术时间、术中出血量、术后疼痛程度、术后住院时间、手术并发症,3个月后随访两组的伤口情况。结果:观察组手术时间长于对照组,差异有统计学意义(P<0.05);术中出血量、手术并发症与对照组相比差异无统计学意义(P>0.05);但术后疼痛程度、术后住院时间及伤口恢复情况优于对照组,差异有统计学意义(P<0.05)。结论:TUSPLC安全可行,具有术后疼痛轻、恢复快、术后腹壁瘢痕不明显等优点,但技术难度较大,需要微创经验丰富的医生开展并推广。

Objective：To explore the clinical application of pucker umbilical laparoscopic cholecystectomy（TUS- PLC）. Methods ：The clinical data of 42 cases with cholecystolithiasis and gallbladder polyps was analyzed from August 2009 to March 2012. 19 cases were defined as observation group treated with the TUSPLC （observation group）, 23 cases（control group）were the control treated with conventional three holes of laparoscopic cholecy stectomy （LC）. The operation time, intraoperative blood loss, postoperative pain degrees and hospital stay, operative complications was compared ,the wound status obtained by follow-up after three months. Results ..The operation time of observation group is less than control group and with statistical significance（P^0. 05）,no obvious difference was observed in the intraoperative blood loss and operative complications between two group and there was no statistical significance（P~ 0. 05）. But the postoperative pain degrees,postoperative hospital stay and wound healing for the observation group were better than the control group and the difference had statistical significance （P〈0.05）. Conclusion：TUSPLC is safe and feasible ,and also with these advantages of minimal postoperative pain,early return to normal activity and less abdominal wall scars retained. But the doctors rich in minimal invasion were necessary to develop and spread due to its great technical difficulties.