经脐单切口微型腔镜胆囊切除术与传统腹腔镜胆囊切除术的比较

摘要

Objective To compare the efficacy of transumbilical single-incision minilaparoscopic cholecystectomy (mini-LC) with conventional LC, and the feasibility of transumbilical single-incision mini-LC with regular instruments. Methods Since June to November 2010, 60 patients with gallbladder disease were assigned to transumbilical single-incision mini-LC ( n = 30) or conventional LC ( n = 30) based on the date of the surgery. The two procedures were carried out by a same group of surgeons. All the instruments used in the mini-LC group were exactly the same as the conventional LC group except for the urethroscope, which was a 3-mm one. The operation time, intraoperative blood loss, postoperative pain score and complications, total hospital cost, and postoperative hospital stay were compared between the two groups. Results Without conversion to open surgery nor postoperative complications, the procedures were completed successfully in both the groups. Compared with the conventional group, mini-LC group showed longer operation time [ (62. 6 ± 30. 6) min vs. (47. 7 ± 21. 6 ) min, t = 2. 179, P = 0. 033 ] , but comparable intraoperative blood loss, postoperative pain score and hospital stay, total hospital cost, the other indicators showed no significant differences (all P>0.05). Conclusion Transumbilical single-incision mini-LC not only shows the advantages of traditional LC, but also has a better cosmetic results and less invasion than the conventional one.%目的 比较微型腔镜下经脐单切口胆囊切除术与传统腹腔镜胆囊切除术( laparoscopic cholecystectomy,LC)的临床效果,探讨应用常规器械行经脐单切口微型腔镜胆囊切除的可行性.方法 2010年6～11月60例胆囊良性疾病按手术日分为2组,由同一手术组医师分别施行经脐单切口微型腔镜胆囊切除术与传统LC,前者除换用3 mm尿道镜外,余均使用同样的设备和操作器械,比较2组手术时间、术中出血量、术后疼痛评分、术后并发症、总住院费用及术后住院时间.结果 2组均完成胆囊切除,无中转开腹手术,术后无并发症发生.传统组手术时间(47.7±21.6) min明显短于单切口组(62.6±30.6)min(t =2.179,P=0.033),2组术中出血量、术后疼痛评分、总住院费用及术后住院时间无显著性差异(P＞0.05).结论 微型腔镜下单切口胆囊切除术可行,不仅具有传统LC的优点,还具有切口隐蔽性好,更好的美容效果等特点.