经脐单孔腹腔镜胆囊切除术在胆囊动脉变异患者的临床效果研究  

Clinical effect of transumbilical single-port laparoscopic cholecystectomy in treating patients with cystic artery variation

作　　者：范伟强[1] 杨彦[1] 韩霖[1] 黄小龙[1] 李望 孙传伟 林师佈 Fan Weiqiang;Yang Yan;Han Lin;Huang Xiaolong;Li Wang;Sun Chuanwei;Lin Shibu(Department of hepatobiliary surgery,the first affiliated hospital of Hainan medical college,Hainan 570102,China;Department of General surgery,the first affiliated hospital of Hainan medical college,Hainan 570102,China)

机构地区：[1]海南医学院第一附属医院肝胆外科,570102 [2]海南医学院第一附属医院普通外科,570102

出　　处：《中华普外科手术学杂志（电子版）》2020年第3期318-321,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：海南医学院科研培育基金(HY2016-21)。

摘　　要：目的探讨经脐单孔腹腔镜下胆囊切除术(LC)与双孔LC在胆囊动脉变异患者的临床效果。方法回顾性分析2016年1月至2018年2月62例行LC患者临床资料,根据手术方法不同将其分为单孔组29例和双孔组33例。运用SPSS 24.0软件进行数据分析,两组患者围术期指标、疼痛评分以(±s)表示,采用独立t检验;术后并发症采用χ^2检验,以P<0.05表示差异有统计学意义。结果两组胆囊动脉变异患者多起源于肝右动脉(40.3%,25/62)及变异肝右动脉(29.0%,18/62),走行多从胆囊颈/胆囊体左侧进入胆囊(37.1%,23/62)和胆囊两侧分别进入胆囊(48.4%,30/62)。经脐单孔组手术时间、住院时间、术后6 h疼痛程度、止痛药使用率及切口满意度均优于双孔组(P<0.05)。两组患者术后并发症及术后随访期并发症发生率差异无统计学意义(P>0.05)。结论胆囊动脉变异患者行经脐单孔LC和双孔LC术中均安全可行,经脐单孔LC术中创伤更小,术后患者更易恢复,值得临床推广。Objective To investigate the clinical effect of transumbilical single-port laparoscopic cholecystectomy(LC)and double-port LC in treating patients with cystic artery variation.Method Retrospective analysis of clinical data were performed in 62 patients underwent LC from January 2016 to February 2018.According to the different surgical methods,they were divided into single-port group(29 cases)and double-port group(33 cases).Statistical analysis were performed by using SPSS24.0 software.Measurement data such as perioperative indicators and pain scores were represented as and were examined by using independent t test.Postoperative complications were analyzed by usingχ^2 test.A P value of<0.05 was considered as statistical significant difference.Result The variation of cystic artery in both two groups mostly originated from the right hepatic artery(40.3%,25/62)or the variant right hepatic artery(29.0%,18/62).Most of the variant gallbladder arteries enter the gallbladder from its neck/left side(37.1%,23/62)or from both sides of the gallbladder respectively.The operation time,hospitalization time,pain scores of 6 hours after operation,utilization rate of analgesics and the satisfaction of incision were all better in the single-port group than those in the double-port group respectively(P<0.05).There were no significant difference between the two groups in terms of complications after surgery or during follow-up(P>0.05).Conclusion Both transumbilical single-port LC and double-port LC are safe and feasible in treating patients with cystic artery variation.However transumbilical single-port LC is worthy of clinical promotion with less trauma and rapid recovery after surgery.

关 键 词：腹腔镜 胆囊切除术 胆囊动脉变异 单孔 治疗结果 

分 类 号：R657.4[医药卫生—外科学]