脐周三孔法腹腔镜胆囊联合阑尾切除术42例

Transumbilical Triple-hole Approach Laparoscopic Cholecystectomy Combined with Appendectomy: a Report of 42 Cases

目的探讨脐周三孔法腹腔镜胆囊联合阑尾切除术的可行性。方法2012年3～12月行脐周三孔腹腔镜胆囊联合阑尾切除术42例。全身麻醉。采用平卧位，气腹压力12～14mmHg（1mmHg=0．133kPa）。以脐为中心，沿脐周皮肤皱褶线画圆，从5、8、1点方向分别置入10、5、10mmtrocar，入镜观察胆囊和阑尾情况，先行胆囊切除后再行阑尾切除术。结果42例采用普通腹腔镜器械经脐周行三孔胆囊切除联合阑尾切除术取得成功。手术时间60～130min，平均78rain。40例术后随访2～12个月（平均7个月），腹壁瘢痕不明显，无并发症发生。结论脐周三孔腹腔镜胆囊联合阑尾切除术安全可行，在有条件的医院可以作为腹腔镜胆囊切除联合阑尾切除的改进术式推广。

Objective To evaluate the feasibility of the transumbilical triple-hole laparoscopic cholecystectomy combined with appendectomy. Methods From March 2012 to December 2012, a total of 42 cases subject to transumbilical triple-hole laparoscopic cholecystectomy combined with appendectomy in this hospital were retrospectively analyzed. Under general anesthesia, the patients were maintained at recumbent position, with a pneumoperitoneum pressure of 12 -14 mm Hg. With the navel as the center, lO-mm, 5-ram, and 10-ram trocars were introduced at 5, 8, and 1 o＇ clock direction along the circumference of periumbilical skin fold, respectively. After observation and exploration, cholecystectomy and appendectomy were successively performed. Results All the patients were successfully treated, without any complications. The operation time was 60 - 130 min （mean, 78 min）. A follow-up observation for 2 - 12 month （mean, 7 month） was conducted in 40 cases. No obvious scars or complications were noted. Conclusions Transumbilical triple-hole laparoseopic cholecystectomy combined with appendectomy is a safe and feasible operation. This method can be carried out at large scale in hospitals as improved alternative of cholecystectomy combined with appendectomy.