单孔腹腔镜胆囊切除术的学习曲线  被引量:2

The learning curve of single-incision laparoscopic cholecystectomy

在线阅读下载全文

作  者:修鹏[1] 桑江勇 木合塔尔.吾布力卡斯木 李可为[1] 王贵阳[1] 辛诚[1] 李甫[1] 王辉[1] 沈火剑[1] 何敏[1] 

机构地区:[1]上海交通大学医学院附属仁济医院,上海200127 [2]新疆喀什地区第二人民医院

出  处:《腹腔镜外科杂志》2014年第12期926-929,共4页Journal of Laparoscopic Surgery

基  金:上海市卫生局课题基金(编号:20124355)

摘  要:目的:总结单孔腹腔镜胆囊切除术(single-incision laparoscopic cholecystectomy,SILC)的经验与体会,初步研究SILC的学习曲线。方法:回顾分析2011年7月至2014年4月40例SILC患者的临床资料,按施行手术的先后顺序分成A、B、C、D四组,每组10例,分析手术时间、出血量、术后并发症等指标。结果:本组40例患者均成功施行SILC,无中转常规腹腔镜手术或开腹手术。均未放置腹腔引流管。手术时间平均(61.0±19.7)min,A组手术时间平均(79.5±21.4)min,B组平均(68.0±15.7)min,C组平均(49.3±10.0)min,D组平均(47.3±9.2)min,其中B、C组差异有统计学意义(P〈0.05),A、B组,C、D组差异均无统计学意义(P〉0.05)。手术出血量平均(15.3±21.1)ml。B组术后腹腔内出血1例,经保守治疗而愈,A组、B组、D组各有1例切口感染,B组、C组各有1例术中胆囊破裂,术后无黄疸、胆漏、胆管损伤、脐部切口疝等并发症发生,瘢痕不明显,美容效果满意。术后第1天进低脂半流质饮食,术后1~3 d出院。结论:SILC是相对安全的,随着手术例数的增加,手术时间明显缩短,学习曲线约为20例。Objective: To summarize the experience and understanding of single-incision laparoscopic cholecystectomy( SILC),and preliminarily study the learning curve of SILC. Methods: The clinical data of 40 patients who underwent SILC from Jul.2011 to Apr. 2014 were retrospectively analyzed. According to the operation sequence,these patients were divided into four groups: A,B,C and D with 10 cases in each group,then the indexes such as the operation time,blood loss,postoperative complications and so on were analyzed. Results: All 40 patients were successfully performed SILC and none of them was converted to conventional laparoscopic operation or laparotomy. No abdominal drainage tube was placed in these cases. Operation time was( 61. 0 ± 19. 7) min on average,the mean operative time of A,B,C and D group was( 79. 5 ± 21. 4) min,( 68 ± 15. 7) min,( 49. 3 ± 10. 0) min,and( 47. 3 ± 9. 2) min.There was statistically significant difference between group B and C( P〈0. 05),however,the difference between group A and B,C and D had no statistical significance( P〉0. 05). The intraoperative hemorrhage was( 15. 3 ± 21. 1) ml on average. 1 case in group B suffered from postoperative intraperitoneal hemorrhage,and cured after conservative treatment,1 case of incision infection was found in group A,B and D,group B and C occurred 1 case of intraoperative gallbladder rupture respectively. No postoperative complications such as jaundice,bile leakage,bile duct injury or umbilical hernia occurred. The cosmetic result was satisfactory with almost no visible scar.Patients had low-fat semi-liquid diet on the first post-operative day. The mean hospital stay after operation was 1-3 d. Conclusions: SILC is relatively safe. The operation time could significantly shorten as the number of operative cases increases,the learning curve is approximate 20 cases.

关 键 词:胆囊切除术 腹腔镜 单孔 学习曲线 

分 类 号:R657.4[医药卫生—外科学]

 

参考文献:

正在载入数据...

 

二级参考文献:

正在载入数据...

 

耦合文献:

正在载入数据...

 

引证文献:

正在载入数据...

 

二级引证文献:

正在载入数据...

 

同被引文献:

正在载入数据...

 

相关期刊文献:

正在载入数据...

相关的主题
相关的作者对象
相关的机构对象