经脐单孔腹腔镜胆囊切除术在巨大胆囊结石患者中的应用价值  

Application value of transumbilical single incision laparoscopic cholecystectomy in patients with huge gallstones

作　　者：郝琪伟[1] 李健雄 耿智敏[2] HAO Qiwei;LI Jianxiong;GENG Zhimin(Yulin No.2 Hospital,Yulin 719000;the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]榆林市第二医院,陕西榆林719000 [2]西安交通大学第一附属医院,陕西西安710061

出　　处：《临床医学研究与实践》2023年第29期17-20,共4页Clinical Research and Practice

基　　金：陕西省重点研发计划项目(No.2022SF-606)。

摘　　要：目的比较经脐单孔腹腔镜胆囊切除术(SILC)与传统三孔法腹腔镜胆囊切除术(LC)在巨大胆囊结石(结石直径≥3 cm)患者中的应用价值。方法选择2018年9月至2021年9月收治的100例接受胆囊切除术治疗的巨大胆囊结石患者作为研究对象,依据随机数字表法将其分为对照组和研究组,各50例。对照组采用传统三孔法LC治疗,研究组采用SILC治疗。比较两组的切口总长度、术中出血量、手术耗时、术后肛门排气时长、住院时长、住院费用、视觉模拟评分量表(VAS)及切口美观满意度评分、术后并发症发生情况。结果研究组的切口总长度、术后肛门排气时长、住院时长短于对照组,术中出血量、住院费用少于对照组,差异具有统计学意义(P<0.05);两组的手术耗时比较,差异无统计学意义(P>0.05)。研究组术后24、48 h的VAS评分低于对照组,切口美观满意度评分高于对照组,差异具有统计学意义(P<0.05)。研究组的并发症总发生率为4.00%,低于对照组的16.00%,差异具有统计学意义(P<0.05)。结论SILC在巨大胆囊结石患者治疗中具有显著应用价值,其与传统三孔法LC相比,术中出血量更少,切口长度、术后肛门排气及住院时长更短,术后疼痛程度更轻,患者对切口美观满意度更高,并发症发生率及住院费用更低。Objective To compare the application value of transumbilical single incision laparoscopic cholecystectomy(SILC)and traditional three-port laparoscopic cholecystectomy(LC)in patients with huge gallstones(stone diameter≥3 cm).Methods A total of 100 patients with huge gallstones who underwent cholecystectomy from September 2018 to September 2021 were selected as the research objects.According to the random number table method,the patients were divided into control group and study group,with 50 cases in each group.The control group was treated with traditional three-port LC,and the study group was treated with SILC.The total length of incision,intraoperative blood loss,operation time,postoperative anal exhaust time,hospitalization time,hospitalization cost,Visual Analogue Scale(VAS)and incision aesthetic satisfaction scores and postoperative complications were compared between the two groups.Results The total length of incision,postoperative anal exhaust time and hospitalization time in the study group were shorter than those in the control group,and the intraoperative blood loss and hospitalization cost were less than those in the control group,and the differences were statistically significant(P<0.05);there was no significant difference in operation time between the two groups(P>0.05).The VAS score of the study group at 24 and 48 h after operation was lower than that of the control group,and the incision aesthetic satisfaction score was higher than that of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the study group was 4.00%,which was lower than 16.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion SILC has a significant application value in the treatment of patients with huge gallstones.Compared with traditional three-port LC,SILC has less intraoperative blood loss,shorter incision length,postoperative anal exhaust and hospitalization time,lighter postoperative pain,higher patients'satisfaction with

关 键 词：经脐单孔腹腔镜胆囊切除术 传统三孔法腹腔镜胆囊切除术 巨大胆囊结石 

分 类 号：R657.4[医药卫生—外科学]