经脐纵切口行单孔腹腔镜胆囊切除术治疗胆囊结石的临床效果  

Clinical effect of umbilical longitudinal incision in single port laparoscopic cholecystectomy for the treatment of cholecystolithiasis

作　　者：胥龙龙 李富荣 XU Longlong;LI Furong(Department of Hepatobiliary Minimally Invasive Surgery,Tianshui 407 Hospital,Tianshui 741000,China)

机构地区：[1]天水四零七医院肝胆(微创)外科,甘肃天水741000

出　　处：《腹腔镜外科杂志》2024年第11期848-852,共5页Journal of Laparoscopic Surgery

摘　　要：目的:探讨经脐纵切口行单孔腹腔镜胆囊切除术(LC)治疗胆囊结石的临床效果。方法:回顾分析2023年8月至2024年2月收治的95例胆囊结石患者的临床资料,按治疗方法分为单孔组(n=51)与三孔组(n=44),单孔组经脐纵切口行单孔LC,三孔组行三孔法LC;对比分析两组手术时间、术中出血量、术后6 h疼痛评分、术后住院时间、切口满意度、切口感染率及住院费用。结果:单孔组中1例患者因炎症较重、胆囊颈部结石改行两孔法LC,余50例均完成单孔手术。单孔组术后6 h疼痛评分低于三孔组,术后住院时间短于三孔组,切口满意度高于三孔组,手术时间长于三孔组,住院费用高于三孔组,差异有统计学意义;两组性别、年龄、术中出血量、切口感染率差异无统计学意义。结论:经脐纵切口行单孔LC安全、可靠,术后切口隐蔽、美观,疼痛轻,康复快,住院时间短,具备一定腹腔镜外科经验的医生经过专业训练可独立完成,值得在临床推广应用。Objective:To evaluate the clinical outcomes of single-incision laparoscopic cholecystectomy(SILC)via a transumbilical longitudinal incision in the treatment of cholecystolithiasis.Methods:A retrospective analysis was conducted on clinical data of 95 patients with gallbladder stones treated between Aug.2023 and Feb.2024.Patients were divided into the single-incision group(n=51)and the three-port group(n=44)according to treatment method.The single-incision group underwent SILC via a transumbilical longitudinal incision,while the three-port group received conventional three-port laparoscopic cholecystectomy.The two groups were compared in terms of operative time,intraoperative blood loss,postoperative pain scores at 6 h,postoperative hospital stay,incision satisfaction,incidence of incision infections,and hospitalization costs.Results:In the single-incision group,one case was converted to two-port laparoscopic cholecystectomy due to severe inflammation and impacted stones in the gallbladder neck.The remaining 50 cases were successfully completed using the single-incision technique.The single-incision group demonstrated significantly lower postoperative pain scores at 6 h(P=0.015),shorter hospital stay,and higher incision satisfaction compared to the three-port group.However,the operative time was longer,and hospitalization costs were higher in the single-incision group,with statistically significant differences.There were no significant differences between the two groups in terms of gender,age,intraoperative blood loss,or incision infection rate.Conclusions:SILC via a transumbilical longitudinal incision is a safe and reliable procedure.It offers advantages such as concealed and aesthetic incisions,reduced postoperative pain,faster recovery,and shorter hospital stay.After specialized training,surgeons with laparoscopic experience can independently perform this technique,making it a valuable option for clinical promotion.

关 键 词：胆囊切除术 腹腔镜 经脐 单切口 三孔法 

分 类 号：R657.4[医药卫生—外科学]