X-CONE经脐单通道腹腔镜胆囊切除术治疗胆囊疾病的疗效

Surgical efficacy of X-CONE trans-umbilical single-port laparoscopic cholecystectomy in treatment of gallbladder diseases

目的探讨X-CONE经脐单通道腹腔镜胆囊切除术治疗胆囊疾病的疗效。方法回顾性分析402例接受腹腔镜胆囊切除术患者的临床资料,根据手术方式将其分为单孔组(X-CONE经脐单通道腹腔镜胆囊切除术)181例及传统组(三孔法腹腔镜胆囊切除术)221例,比较2组的手术时间、术中出血量、术后住院时间、并发症、疼痛评分及住院总费用等指标。结果402例患者均顺利完成腹腔镜胆囊切除术,无中转开腹者。单孔组181例中98.3%(178/181)成功完成X-CONE经脐单通道腹腔镜胆囊切除术,3例中转接受传统三孔法腹腔镜胆囊切除术。2组患者术中出血量比较差异无统计学意义(P>0.05)。单孔组手术时间长于传统组(P<0.05),但其术后住院时间、胆囊窝积液、住院总费用均优于传统组(P均<0.05)。单孔组的术后第1日疼痛程度弱于传统组(P<0.05)。2组均无伤口感染、胆漏、腹腔出血、胆道损伤等并发症。术后随访12~24个月,无患者出现脐疝、胆道狭窄等并发症,所有患者对美容效果均满意。结论X-CONE经脐单通道腹腔镜胆囊切除术治疗胆囊疾病安全可靠,患者恢复快,费用少。

Objective To evaluate the surgical efficacy of X-CONE trans-umbilical single-port laparoscopic cholecystectomy in the treatment of gallbladder diseases.Methods Clinical data of 402 patients undergoing laparoscopic cholecystectomy were retrospectively analyzed.According to the surgical approaches,all patients were divided into the single-port group(n=181,X-CONE trans-umbilical single-port laparoscopic cholecystectomy)and the traditional group(n=221,three-port laparoscopic cholecystectomy).The operation time,intraoperative blood loss,length of postoperative hospital stay,postoperative complications,pain score and total hospitalization expenses were statistically compared between two groups.Results All 402 patients successfully completed the laparoscopic cholecystectomy with no switch to open surgery.Of the 181 cases in the single-port group,178 patients(98.3%)successfully completed the X-CONE trans-umbilical single-port laparoscopic cholecystectomy,and 3 cases were switched to conventional three-port laparoscopic cholecystectomy.Intraoperative blood loss did not significantly differ between two groups(P>0.05).The operation time in the single-port group was significantly longer than that in the traditional group(P<0.05).However,the length of postoperative hospital stay,cystic fossa effusion and hospitalization expense in the single-port group were remarkably better compared with those in the traditional group(all P<0.05).In the single-port group,the severity of pain at postoperative 1 d was considerably less than that in the traditional group(P<0.05).No wound infection,bile leakage,abdominal hemorrhage,biliary tract injury or other complications were observed in two groups.During postoperative follow-up for 12-24 months,no umbilical hernia,biliary stricture or other complications were found.All patients were satisfied with the cosmetic effect.Conclusion X-CONE trans-umbilical single-port laparoscopic cholecystectomy is a safe and reliable treatment of gallbladder diseases,which yields fast recovery and low cost.