经脐单孔腹腔镜胆囊切除术治疗胆囊结石疗效分析  

Clinical efficacy of transumbilical single-port laparoscopic cholecystectomy in treatment of cholecystolithiasis

作　　者：邹瑞 王一尧 黄泽鹏 李铎 Zou Rui;Wang Yiyao;Huang Zepeng;Li Duo(Department of Hepatobiliary and Pancreatic Surgery,Hainan Cancer Hospital,Haikou 570312,China)

机构地区：[1]海南省肿瘤医院肝胆胰外科,海口570312

出　　处：《中华肝脏外科手术学电子杂志》2024年第3期334-338,共5页Chinese Journal of Hepatic Surgery(Electronic Edition)

基　　金：海南省重点研发项目(ZDYF2022SHFZ118);海南省肿瘤医院科研基金(2023ZD05);海南省‘南海新星’医疗卫生人才平台项目。

摘　　要：目的 探讨经脐单孔腹腔镜胆囊切除术(LC)治疗胆囊结石的安全性和疗效。方法 回顾性分析2018年6月至2022年6月在海南省肿瘤医院行LC的201例胆囊结石患者临床资料。其中男91例,女110例;年龄27~74岁,中位年龄51岁。患者均签署知情同意书,符合医学伦理学规定。根据手术方式,将患者分为单孔LC组(单孔组,107例)和三孔LC组(三孔组,94例)。两组手术时间、满意度评分等比较采用t检验,并发症发生率、中转开腹率等比较采用χ^(2)检验或Fisher确切概率法。结果 两组患者均手术顺利,单孔组中转开腹1例,三孔组无中转开腹,差异无统计学意义(P=0.347)。两组术中出血量、手术时间、住院时间、住院费用等差异无统计学意义(P>0.05);亚组分析显示,对于胆囊结石>2 cm的患者,单孔组平均手术时间为(44±8)min,明显短于三孔组的(55±7)min(t=-12.685,P<0.05)。单孔组术后并发症发生率为1.9%(2/107),三孔组相应为2.1%(2/94),差异无统计学意义(χ^(2)=0.418,P>0.05)。单孔组患者满意度评分为(42.8±2.8)分,明显高于三孔组(33.7±4.9)分(t=32.710,P<0.05)。结论 经脐单孔LC治疗胆囊结石安全、有效,且具有美容效果更佳,患者满意度高等优势;对于大于2 cm的胆囊结石,单孔法手术时间更短。Objective To evaluate the safety and efficacy of transumbilical single-port laparoscopic cholecystectomy (LC) in the treatment of cholecystolithiasis.Methods Clinical data of 201 patients with cholecystolithiasis who underwent LC in Hainan Cancer Hospital from June 2018 to June 2022 were retrospectively analyzed.Among them,91 patients were male and 110 female,aged from 27 to 74 years,with a median age of 51 years.The informed consents of all patients were obtained and the local ethical committee approval was received.According to surgical methods,all patients were divided into single-port LC group (single-port group,n=107) and three-port LC group (three-port group,n=94).Operation time and satisfaction score between two groups were compared by t test.The incidence of complications and the conversion rate to open surgery were compared by using Chi-square test or Fisher's exact test.Results All patients intwo groups successfully completed the surgery.1 patient in the single-port group was converted to open surgery,and none in the three-port group,with no statistical significance between two groups (P=0.347).No statistical significance was found in intraoperative blood loss,operation time,length of hospital stay and hospitalization expenses between two groups (P>0.05).Subgroup analysis showed that for patients with cholecystolithiasis of >2 cm,the average operation time in the single-port group was (44±8) min,significantly shorter than (55±7) min in the three-port group (t=-12.685,P<0.05).The incidence of postoperative complications in the single-port group was 1.9%(2/107),and 2.1%(2/94) in the three-port group,with no statistical significance (χ2=0.418,P>0.05).In single-port group,the satisfaction score of patients was 42.8±2.8,significantly higher than 33.7±4.9 in the three-port group (t=32.710,P<0.05).Conclusions Transumbilical single-port LC is safe and efficacious treatment of cholecystolithiasis,which has the advantages of better cosmetic effect and higher satisfaction score.For patients with cholecystolit

关 键 词：胆囊结石 胆囊切除术 经脐单孔法 三孔法 美容 手术时间 

分 类 号：R657.4[医药卫生—外科学]