204例“悬吊法”经脐单孔腹腔镜胆囊切除术的临床应用体会

Clinical application of transumbilical suture-suspension single port laparoscopic cholecystectomy in 204 cases

目的探讨"悬吊法"经脐单孔腹腔镜胆囊切除术的临床应用效果。方法回顾性分析2013年6月至2016年3月在广州中医药大学第一附属医院三外科开展的"悬吊法"经脐单孔腹腔镜胆囊切除术治疗胆囊结石或胆囊息肉的204例患者的临床资料,其中男性81例,女性123例;年龄22~84岁,平均(49.8±13.8)岁;胆囊结石186例,胆囊息肉18例。结果最终共有198例患者成功施行了"悬吊法"经脐单孔腹腔镜胆囊切除,平均手术时间(55.96±15.11)min,平均住院时间(6.07±1.85)d,无术后胆漏、出血及切口感染等并发症发生。余6例因解剖困难等原因中转为三孔法腹腔镜下行胆囊切除,"悬吊法"经脐单孔手术成功率为97.06%(198/204)。结论 "悬吊法"经脐单孔腹腔镜胆囊切除是确切可行的,经过短暂的手术学习曲线后,可熟练掌握操作技巧,缩短手术时间,而且切口小,伤口疼痛轻,住院时间短,恢复快,手术效果几乎达到无创,更加接近患者追求的美容效果,符合患者心理需求,具有临床推广价值。

Objective To investigate the clinical application of the transumbilical suture-suspension single port laparoscopic cholecystectomy（LC）. Methods The clinical data of 204 patients with gallbladder stones or gallbladder polyp who received transumbilical suture-suspension single port LC（186 patients with gallbladder stones, 18 patients of gallbladder polyp） in the Third Department of Surgery in First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from June 2013 to March 2016 were retrospectively reviewed. Among the patients, 81 were male,and 123 were female, ranging in age from 22 to 84 years old, with an average of（49.8±13.8） years old. Results The transumbilical suture-suspension single port LC were performed successfully in 198 patients, with an average operation time of（55.96±15.11） min, and an average hospitalization time of（6.07±1.85） days. The complications such as postoperative bile duct injury, bleeding and incision infection didn＇t occur in 204 patients. Six cases changed to three-port LC,and the total surgical success rate was 97.06%（198/204）. Conclusion Transumbilical suture-suspension single port laparoscopic cholecystectomy is feasible, minimally invasive, with less pain, which meets the psychological needs of patients.