三孔法微型腹腔镜在胆囊切除术中的应用

The application of three-trocar mini-laparoscopic cholecystectomy

目的 探讨三孔法微型腹腔镜在胆囊切除术中的临床应用价值。 方法 90例慢性结石性胆囊炎和胆囊息肉样病变随机分成两组 ,分别进行三孔法微型腹腔镜下胆囊切除术 (Mini-laparoscop iccholecystectomy ,MLC)和常规孔法腹腔镜胆囊切除术 (Laparoscopiccholecystectomly,LC)。比较两组的中转率、手术时间、术后 6小时疼痛程度和并发症。 结果 两组均无并发症发生。MLC组中 2例因操作困难 ,中转LC。MLC组与LC组手术时间分别为 (5 4 8± 11 3)min和 (5 1 0± 11 0 )min ,(t =1 6 1,P >0 0 5 ) ;术后疼痛程度分别为 (2 0± 0 7)分和 (2 5± 0 8)分 ,(t=- 3 0 2 ,P <0 0 1)。 结论 在熟练掌握LC的基础上 ,开展MLC是安全、有效的。

Objective To explore the clinical application of three-trocar mini-laparoscopic cholecystectomy(MLC). Methods 90 cases of chronic calculus cholecystitis or polypoid lesion of gallbladder were divided randomly into two groups: group MLC and group LC. The patients in group LC were operated on by traditional LC, the ones in group MLC by three-trocar MLC.Conversion rate, operative time(OT), pain degree in 6 hours postoperatively and complications were compared between the two groups. Results No complication occurred in the two groups. 2 patients in group MLC were converted to traditional LC due to difficult procedures. The OT of the two groups was (54 8±11 3)min and (51 0±11 0)min respectively (t=1 61,P>0 05), and the postoperative pain degree score was (2 0±0 7) points and (2 5±0 8) points respectively (t=-3 02, P<0 01). Conclusions MLC is a safe and efficient method on the basis of skillful command of LC.