经脐单孔与经典腹腔镜保胆取石术的对比研究  

A comparative study of transumbilical single-port and classic laparoscopic gallbladder-preserving cholelithotomy

作　　者：黄安华[1] 胡海[1] 赵刚[1] 徐安安[1] 王维东[1] 何川琦[1] 丁侃[1] 李海东[1] 蔡景理[1] 

机构地区：[1]同济大学附属东方医院,上海200120

出　　处：《腹腔镜外科杂志》2015年第1期54-57,共4页Journal of Laparoscopic Surgery

基　　金：上海市浦东新区卫生和计划生育委员会卫生科技项目(编号:PW2011B-3)

摘　　要：目的:对比经脐单孔腹腔镜保胆取石术与经典腹腔镜保胆取石术的临床效果。方法:选择2011年7月至2014年6月拟行腹腔镜保胆取石术的患者92例,随机分为单孔腹腔镜组(单孔组,n=45)与三孔腹腔镜组(经典三孔组,n=47)。对比分析两组患者手术时间、术中出血量、并发症、术后疼痛评分、术后住院时间、总费用、患者满意度等指标。结果:两组术中出血量、并发症发生率、术后住院时间、总费用差异无统计学意义(P>0.05)。两组手术时间、术后第1天疼痛视觉模拟评分、患者美容满意度差异均有统计学意义(P<0.05)。结论:经脐单孔腹腔镜保胆取石术是安全、可行的,美容效果较好,可减轻患者的术后疼痛,但应在严格控制手术指征的前提下适度开展。Objective： To compare the clinical results of gallbladder-preserving cholelithotomy of transumbilical endoscopic surgery（ TUES） and classic laparoscopic gallbladder-preserving cholelithotomy（ CLC）. Methods： Clinical data of 92 patients with cholecystolithiasis who underwent TUES or CLC were retrospectively analyzed from Jul. 2011 to Jun. 2014 in department of general surgery of East Hospital of Tongji University,patients were randomly divided into TUES group（ n = 45） and 3-port CLC group（ n = 47）. Two groups were compared in operative time,blood loss,complications,postoperative pain scores,postoperative hospital stay,total costs and patient satisfaction. Results： There was not statistical difference between the TUES group and CLC group in blood loss,complications,postoperative hospital stay and total cost（ P〈0. 05）. In the TUES group and CLC group,surgical time was（ 41 ± 12） min and（ 22 ±10） min,postoperative pain scores was（ 2. 6 ± 1. 2） and（ 4. 3 ± 1. 7）,cosmetic satisfaction scores was（ 98. 3 ± 0. 3） and（ 92. 7 ±0. 7） respectively,these results were significantly different between the two groups（ P〉0. 05）. Conclusions： TUES of gallbladder-preserving cholelithotomy is safe and feasible,not only achieves very good cosmetic results,but also reduces postoperative pain,can be appropriately carried out under the strict control of surgical indications.

关 键 词：胆囊结石病 腹腔镜检查 经脐 单孔 保胆取石术 

分 类 号：R657.4[医药卫生—外科学]