单切口腹腔镜胆囊切除术与腹腔镜胆囊切除术的病例对照研究  

Case - control study of single - incision laparoscopic cholecystectomy vs. laparoscopic cholecystectomy

作　　者：俞亚红[1] 魏洪亮[1] 高志强[1] 丁志强[1] 陈勇军[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院普外科 ,武汉430030

出　　处：《临床外科杂志》2011年第7期473-475,共3页Journal of Clinical Surgery

摘　　要：目的回顾性分析单切口腹腔镜胆囊切除术（SILC）与传统腹腔镜胆囊切除术（LC）的优劣性。方法19例SILC及46例LC患者的临床资料，比较两者的手术时间、术中出血量、术后并发症、中转率、术后疼痛、住院时间、切口长度的差异。结果SILC手术耗时（49．00±8．34）min长于LC（P=0．000）。术中出血量差异无统计学意义。两组均无中转、术后无并发症；SILC与Lc术后患者第一天疼痛评分、术后第三天疼痛评分、总疼痛天数差异均无统计学意义。两者住院时间差异无统计学意义。SILC切口长度（22．5±3．5）mm短于LC切口长度（P=0．000）。结论SILC总切口长度短于LC总切口长度，切口效果更美观。SILC能安全地用于单纯胆囊结石、胆囊息肉。同时对于没有严重合并症和腹部手术史的胆囊疾病患者SILC也是一种理想的手术选择。Objective To retrospectively analyze the advantages and disadvantages of single - incision laparoscopic cholecystectomy （SILC） vs. laparoscopic cholecystectomy （LC）. Methods SILC and LC were compared in the aspects of operative duration, estimated blood loss, complications, conversion rate,patients＇pain, hospital stay, and wound length by retrospectively analyzing the clinical documents of 19 patients undergoing SILC and 46 patients undergoing LC in Tongji hospital. Results The operative duration of SILC was longer than that of LC （49.0 ± 8. 340 min, P = 0. 000） ; The mean estimated blood loss for patients undergoing SILC was not significantly different from that of patients undergoing LC. There were no complications or conversion in two groups ; In terms of pain scores on the first day and the third day after operation as well as the total number of days of patients pain, there was no significant difference between patients undergoing SILC and those undergoing LC; The hospital stay of the two groups were the same ;The wound length was significantly shorter in SILC （22.5 ± 3.5 mm） than in LC procedures （ P = 0. 000 ）. Conclusion Mean operative duration was significantly longer in SILC procedures. Mean estimated blood loss, postoperative pain score and hospital stay in patients undergoing SILC were not significantly different from those in patients undergoing LC procedures. Mean wound length was significantly shorter in SILC proce- dures and the wound was more beautiful. SILC is a safe and feasible evolving approach for gallbladder stones and gallbladder polyps without complications. It is also an excellent alternative to the patients with uncomplicated disease and no previous abdominal surgery history.

关 键 词：腹腔镜胆囊切除术 单切口腹腔镜胆囊切除术 单孔腹腔镜 

分 类 号：R608[医药卫生—外科学]