摘要
目的对比经脐单孔与三孔腹腔镜胆总管切开胆道探查术的手术效果,探讨普通器械经脐单孔腹腔镜胆道探查术（TUSILCBDE）的临床应用价值及前景。方法总结分析2013年1月-2013年12月云南省第一人民医院肝胆一科行腹腔镜下胆总管切开胆道探查术的患者83例临床资料,其中,48例行TUSILCBDE（A组）,35例行三孔腹腔镜胆道探查术（TLCBDE）（B组）。对术中出血量、术后住院时间、疼痛视觉模拟评分（VAS）评分及并发症等指标进行比较。结果术中出血量、术后住院时间、疼痛VAS评分及并发症方面,A、B组差异无显著性（P〉0.05）。A组手术时间较B组长,但差异无显著性（P〉0.05）。术后满意程度评分A组优于B组,差异有显著性（P〈0.05）。所有病例随访6～18个月,平均13个月,均未出现腹痛、发热及黄疸等症状,B超未见结石复发。结论经脐单孔腹腔镜胆道探查术具有创伤小、疼痛轻及患者满意度高等优点,在有经验的外科医师是安全可行的。
【Objective】 To compare the efficiency of laparoscopic common bile duct exploration by transumbilical single-incision and three ports, explore the clinical applications and prospect of transumbilical single incision laparoscopic common bile duct exploration（TSILCBDE） by common instruments.【Method】A retrospective analysis involved totally 83 patients who underwent laparoscopic common bile duct exploration in our hospital from January 2013 to December 2013. Among the cases, Group A was TSILCBDE, which was performed on 48 cases, and Group B was three-port laparoscopic common bile duct exploration（TLCBDE） in the other 35 cases. The intraoperative blood loss, hospital stay, visual analogue scale（VAS） score of postoperative pain and postoperative complications were compared between the two groups.【Result】 No significant difference was detected in the intraoperative blood loss, hospital stay, postoperative pain VAS score and postoperative complications to open surgery between the two groups（ P〈0.05）. Although the operate time of group A was longer than group B, but there was still no statistical significance（ P〈0.05）. However,TSILCBDE group showed a significantly higher postoperative satisfaction score（ P〈0.05）. In both of the groups, all the patients received a follow-up for an average 13 months（ranged from 6 to 18 months）, during which had no abdominal pain, fever, or jaundice; and reviewed by B-ultrasonography showed no appeared stones. 【Conclusions】TSILCBDE showed that it had the advantages of little trauma, ache and a highly satisfaction in patients, and was safe and feasible in skilled surgeons.
出处
《中国内镜杂志》
北大核心
2015年第7期757-760,共4页
China Journal of Endoscopy
基金
云南省卫生科技计划项目(No:2011WS0007)
云南省卫生科技基金资助项目(No:2012WS0076)
关键词
经脐
单孔
腹腔镜胆道探查
the transumbilical
single incision
laparoscopic bile duct exploration
