经脐单孔腹腔镜下胆囊切除术的临床可行性研究

Clinical feasibility of transumbilical single-port laparoscopic cholecystectomy

目的:探讨经脐单孔腹腔镜胆囊切除术的临床可行性。方法:回顾性分析包头医学院第一附属医院普通外科2012年8月—2013年10月期间85例胆囊结石、胆囊息肉行腹腔镜胆囊切除术患者资料,其中41例行经脐单孔腹腔镜胆囊切除术(单孔组),44例行传统三孔法腹腔镜胆囊切除术(三孔组),比较两组的相关临床指标。结果:腹腔镜手术均获成功,无中转开腹;单孔组手术时间明显长于传统组的[(31.73±4.22)min vs.(15.43±1.81)min,P=0.000];两组术中出血量、术后住院时间、住院费用、切口感染率差异均无统计学意义(均P>0.05);单孔组术后应用镇痛药物比例明显低于三孔组(7.32%vs.34.09%,P=0.003);两组术后均无胆瘘及其他严重并发症。结论:单孔腹腔镜胆囊切除术与传统三孔法腹腔镜胆囊切除术的治疗效果相同,但单孔腹腔镜手术在微创方面更具有优越性。

Objective： To assess the clinical feasibility of transumbilical single port laparoscopic cholecystectomy. Methods： The clinical data of 85 patients with gallstones or gallbladder polyps undergoing laparoscopic cholecystectomy between August 2012 and October 2013 were retrospectively analyzed. Of the patients, 41 cases underwent transumbilical single port laparoscopic cholecystectomy （single-port group）, and 44 cases underwent traditional three-port laparoscopic cholecystectomy （three-port group）. The relevant clinical variables between the two groups were compared. Results： All laparoscopic procedures were successfully conducted, without any open conversion. The operative time in single-port group was significantly longer than that in three-port group [（31.73±4.22） min vs. （15.43± 1.81） rain, P=0.000], and intraoperative blood loss, length of postoperative hospital stay） hospitalization costs and incidence of wound infection showed no statistical difference between the two groups （all P〉0.05）, while the ratio of patients receiving analgesics in single-port group was significantly reduced compared with three-port group （7.31% vs. 34.09%, P=0.003）. No postoperative biliary fistula or other serious complications occurred in any of the two groups. Conclusion： Single-port laparoscopic cholecystectomy has the same therapeutic effect as traditional three-port laparoscopic cholecystectomy, but it has evident superiority in minimal invasiveness.