微创医学

【摘要】目的探讨经脐“三点法”单孔腹腔镜胆囊切除术(SILC)治疗胆囊结石的可行性。方法观察分析因胆囊结石伴慢性胆囊炎行三孔腹腔镜胆囊切除术(LC)(LC组，n=10)和单孔腹腔镜胆囊切除术(SILC组，n=10)的临床资料，对比两组手术时间、术中出血量、术后6 h后疼痛指数、肠蠕动恢复时间、术后住院时间及并发症发生情况。结果SILC组中8例成功，2例因胆囊三角粘连较重改为三孔腹腔镜胆囊切除术，无中转开腹患者； LC组10例均成功；两组均未出现胆漏、胆道损伤等手术并发症。而对于手术时间，LC组明显优于SILC组(P＜0.05)。术后疼痛指数、肠道蠕动恢复和术后住院时间等方面，SILC组均优于LC组(P＜0.05)。结论经脐“三点法”单孔腹腔镜技术应用于胆囊结石伴慢性胆囊炎患者是可行的，相比LC，SILC具有更小的创伤、更好的美容效果、恢复快及住院时间短等优点。

【Abstract】 ObjectiveTo explore the feasibility of transumbilical threespot singleincision laparoscopic cholecystectomy(SILC) for cholecystolithiasis. MethodsClinical data of the patients with cholecystolithiasis complicated with chronic cholecystitis undergoing threeincision laparoscopic cholecystectomy (LC group, n=10) or SILC(SILC group，n=10). The operation duration, intraoperative blood loss, 6hour postoperative pain index, duration for peristalsis recovery, postoperative hospital stay and incidence of complications were compared between the two groups. ResultsIn the SILC group, the operation was successfully completed in 8 cases, conversion to threeincision laparoscopic cholecystectomy occurred in 2 cases due to severe adhesion of Calot′s triangle. The operation was successfully completed in 10 cases of the LC group. No complications including biliary leakage and bile duct injury occurred in any cases. The operation duration of the LC group was shorter than that of the SILC group (P＜0.05). The postoperative pain index, duration for peristalsis recovery and postoperative hospital stay in the SILC group were superior to those in the LC group (P＜0.05). ConclusionTransumbilical threespot SILC is feasible for cholecystolithiasis complicated with chronic cholecystitis. SILC has the advantages of less trauma, better cosmetic result, faster recovery and shorter hospital stay compared to LC. It is worthy of promotion and application.