经脐周三通道腹腔镜胆囊切除术的临床观察  

Comparison between transumbilical three-channel laparoscopic cholecystectomy versus traditional method

作　　者：辛海贝[1] 黄河[1] 

机构地区：[1]上海,解放军第八五医院普通外科,200052

出　　处：《腹部外科》2014年第5期370-372,共3页Journal of Abdominal Surgery

摘　　要：目的探讨应用常规器械行经脐周三通道腹腔镜胆囊切除术（transumbilical three-channel laparoscopic cholecystectomy，TUT-LC）的可行性及优缺点。方法取2013年1月至2014年1月78例因胆囊良性疾病需行胆囊切除术且对美容效果要求较高的病人施行TUT-LC，取同一时期80例年龄、胆囊病变等一般情况相似行传统腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）的病人作为对照组，随访2～14个月，回顾性分析两组手术时间、术中出血量、术后疼痛评分、术后并发症、总住院费用、术后住院时间及病人外观满意度情况。结果LC组手术时间为（35．2±8．2）nfin，明显短于TUT-LC组的（45．4±8．0）min，P〈0．01；两组术中出血量、术后疼痛评分、总住院费用及术后住院时间比较，差异均无统计学意义（P〉0．05）;TUT-LC组无中转传统LC的情况发生，两组均无中转开腹手术病例；均无胆漏等并发症发生；与传统LC比较，TUT-LC能获得更好的病人外观满意度（P〈0．01）。结论应用常规腹腔镜器械行TUT-LC安全可行，较传统LC能取得更好的美容效果。Objective To explore the safety, feasibility and value of transumbilical three-channel laparosc.opic cholecystectomy （TUT-LC）. Methods A retrospective analysis was conducted for patients desiring better cosmetic results and undergoing TUT-LC for benign biliary diseases at our hospital from January 2013 to January 2014. A control group consisted of 80 cases undergoing traditional laparoscopic cholecystectomy （LC） for similar gallbladder disease. Two groups were retrospectively analyzed in operative duration, blood loss, postoperative pain, postoperative complications, total cost of hospitalization, postoperative hospital stay and patient satisfaction with cosmetic results. The follow-up period was 2-14 months. Results Operative duration of LC group was significantly shorter than that of TUT-LC group [（35. 2 ± 8. 2） vs （45.4 ± 8. 0） min,P〈0. 01]. No significant inter-group difference was detected in blood loss, postoperative pain, postoperative complications, total cost of hospitalization or postoperative hospital stay （P〉0. 05）. There was neither conversion into open surgery nor bile leakage. TUT-LC can get a better cosmetic result （P〈0. 01）. Conclusions The operative procedure of TUT-LC is feasible and safe and it may achieve better cosmetic outcomes.

关 键 词：胆囊切除术 腹腔镜 病例对照研究 治疗结果 

分 类 号：R657.4[医药卫生—外科学]