单切口免钛夹腹腔镜胆囊切除术  

Single-incision laparoscopic cholecystectomy without using titanium-clips

作　　者：李宏[1] 万世泽[1] 俞丹松[1] 芦曙辉[1] 毛海香[1] 周新华[1] 王韡[1] 李根丛[1] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院微创外科,315040

出　　处：《中华普通外科杂志》2010年第6期460-462,共3页Chinese Journal of General Surgery

摘　　要：目的 探讨单切口免钛夹腹腔镜胆囊切除术治疗胆囊良性疾病的可行性及安全性.方法 按患者意愿对1890例胆囊良性疾病患者中的1016例采用脐部单切口免钛夹腹腔镜胆囊切除术（单切口组）,实际完成1001例,与同期完成的874例两孔法免钛夹腹腔镜胆囊切除术患者进行比较,采用t检验和x2比较两组的手术时间、术中出血量、术后恢复等情况.结果 单切口组1016例仅15例因胆囊壶腹部炎症严重改为传统的四孔法切除,其余1001例均顺利完成单切口下LC术.两孔法组完成腹腔镜胆囊切除术874例.两组均无胆漏、胆道损伤及手术死亡等严重的手术并发症.单切口组与两孔法组的手术时间无差异[（34.5±5.2）min与（32.0±7.4）min,t=0.063,P=0.526]、术中出血量无差异[（56.5±17.8） ml与（55.2±15.9）ml,t=0.812,P=0.425]、术后住院时间无差异[（3.1±0.8）d与（3.2±O.7）d,t=1.073,P=0.326],而单切口组切口疼痛轻于两孔法组（P=0.000）.结论 单切口免钛夹腹腔镜胆囊切除术安全性好,创伤更小,更美观.Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients（group A） undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients（group B）undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[（34.5 ±5.2） min vs （32.0±7.4）min,t=0.063,P=0.526],the length of postoperative hospital stay[（3.1±0.8）d vs（3.2±0.7）d,t=1.073,P=0.326]and operative hemorrhage[（56.5±17.8）ml vs （55.2±15.9）ml,t=0.812,P=0.425]（P〉0.05） between the two groups,but the postoperative pain was less severe in Group A than that in group B （P=0.000〈0.05）. Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.

关 键 词：胆囊切除术 腹腔镜 单切口 钛夹 

分 类 号：R657.4[医药卫生—外科学]