改良经脐单孔腹腔镜胆囊切除术的临床研究

Clinical study of modified transumbilical single-port laparoscopic cholecystectomy

【目的】探讨改良经脐单孔法腹腔镜胆囊切除术的临床应用前景。【方法】选取2013年1月至2015年12月我院收治60例良性胆囊疾病患者随机分为改良经脐单孔法胆囊切除术(改良组,20例)、TriPort经脐单孔法(Tri Port组,20例)和传统三孔法(传统组,20例),手术由同一位医师完成。详细比较3组患者的手术时间、术中出血量、术后C反应蛋白水平、疼痛指数、术后并发症、住院时间及总住院费用等指标。用疼痛指数(numerical rating scale,NRS)进行描述(0~10)。【结果】改良组疼痛指数、住院总费用明显低于Triport组、传统组(P<0.05);3组患者均未出现术后并发症,手术时间、出血量、住院时间比较无明显差异(P>0.05);改良组CRP术后各时点的值及峰值与Triport组、传统组无显著性变化(P>0.05)。【结论】改良后经脐单孔腹腔镜胆囊切除术安全可行,具有微创、经济、恢复快等优点,具有临床推广价值。

【Objective】To explore the perspective of clinical application of modified transumbilical single-port laparoscopic cholecystectomy.【Methods】A total of 60 patients with benign gallbladder diseases in our hospital were selected from January 2013 to December 2015 and randomly divided into 3 groups： 20 cases undergoing modified transumbilical single-port laparoscopic cholecystectomy in the modified group, 20 cases treated with Tri Port transumbilical single-port laparoscopic cholecystectomy in the Tri Port group and 20 cases undergoing traditional laparoscopic cholecystectomy in the traditional group. All the operations were performed by the same surgeon. b： The clinical data were detailedly compared among the three groups, including operation time, intraoperative blood loss, postoperative C-reactive protein level, pain index, postoperative complications, length of stay and hospitalization expense. Pain index was described by NRS method（0-10）.【Results】The pain index and hospital expense in the modified group were significantly lower than those in the Triport group and traditional group（P〈0.05）. There was no significant difference in the postoperative complications, operation time, blood loss and length of stay（P〉0.05）. The CRP values at each time point and peak value in the modified group were not significant, compared with those in the Triport group and traditional group（P〈0.05）.【Conclusion】Modified transumbilical single-port laparoscopic cholecystectomy is safe and feasible with the advantages of minimal invasion, economic expense and fast recovery. It is worthy of clinical spread.