单孔与传统腹腔镜胆囊切除术治疗急性胆囊炎的对比研究  

Comparative study of single-incision laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy for acute cholecystitis

作　　者：付振刚[1] 成广海[1] 申海军[1] 胡博[1] 黄一凡 杨贝 FU Zhen-gang;CHENG Guang-hai;SHEN Hai-jun(Department of Hepatobiliary,Pancreatic and Splenic Surgery,the Aerospace General Hospital of Xi’an City,Xi’an 710100,China)

机构地区：[1]西安航天总医院肝胆胰脾外科,陕西西安710100

出　　处：《腹腔镜外科杂志》2021年第11期858-862,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨“缝线悬吊减鞘卡”经脐单孔腹腔镜胆囊切除术(SILC)治疗急性胆囊炎的可行性、安全性。方法:回顾分析2017年6月至2020年6月因急性胆囊炎行腹腔镜胆囊切除术(LC)及SILC患者的临床资料,比较LC组(n=91)与SILC组(n=80)的手术时间、术中出血量、术中置管率、术后6 h与24 h疼痛指数、手术并发症、术后首次排气时间、术后住院时间、切口美容满意度等指标。结果:SILC组中74例成功完成手术,LC组中88例成功完成手术,术后两组均发生1例胆漏。两组手术时间、术中出血量、术后6 h切口疼痛评分、术后留置腹腔引流管率差异无统计学意义(P>0.05),SILC组术后24 h疼痛评分、术后首次排气时间、术后住院时间、切口满意度均优于LC组(P<0.05)。结论:“缝线悬吊减鞘卡”SILC治疗发病72 h内急性胆囊炎具有创伤小、美容效果好、术后康复快、住院时间短等优点,手术时间与传统LC相当,安全、可行、易于操作,值得推广。Objective:To discuss the feasibility and safety of gallbladder suture suspension and reducing Trocar in single-incision laparoscopic cholecystectomy(SILC)for acute cholecystitis.Methods:This study enrolled 171 patients who were diagnosed with acute cholecystitis from Jun.2017 to Jun.2020.All patients were divided into laparoscopic cholecystectomy(LC)group(n=91)and SILC group(n=80).Operation time,intraoperative blood loss,rate of drainage tube placement during operation,pain score at 6 h and 24 h after surgery,operative complications,time of postoperative first exhaust,postoperative hospital stay and cosmetic satisfaction were compared between the two groups.Results:In the SILC group 74 patients were operated successfully,in the LC group 88 patients were operated successfully.There was one case of biliary leakage in both groups respectively.There were no significant differences between two groups in terms of operative time,intraoperative blood loss,pain score at 6 h after surgery and the rate of indwelling peritoneal drainage tube(P>0.05).SILC group had advantages over LC group on pain scores at 24 h after surgery,intestinal peristalsis recovery time,postoperative hospital stay and incision satisfaction(P<0.05).Conclusions:Gallbladder suture suspension and reducing Trocar in SILC could be performed for the patients with acute cholecystitis less than 72 h.Compared with LC,SILC is associated with fewer trauma,better cosmetic result,faster recovery and shorter hospital stay.SILC is basically the same as LC in terms of operative duration and is a technology that is safe,feasible,maneuverable and worthy of promotion.

关 键 词：胆囊炎 急性 胆囊切除术 腹腔镜 单孔 对比研究 

分 类 号：R657.41[医药卫生—外科学]