摘要
目的：探讨基层医院应用常规器械行经脐单孔腹腔镜胆囊切除术治疗单纯胆囊结石、胆囊息肉的临床效果、安全性及可行性。方法：回顾分析2012年12月至2014年12月为38例患者行经脐单孔腹腔镜胆囊切除术的临床资料。结果：32例成功完成经脐单孔腹腔镜胆囊切除术,6例经剑突下白线辅助5 mm切口完成手术,无一例中转开腹。手术时间50～100 min,平均（73.1±16.6）min;术中出血量2～10 ml,平均（5.7±2.3）ml;术后无出血、胆漏、胆管损伤等并发症发生。术后3～5 d出院。术后1个月、3个月、6个月、12个月门诊或电话随访,1例患者进食后腹胀,对症治疗后好转,3例患者复查B超提示胆总管代偿性扩张,无黄疸。手术切口瘢痕隐蔽,无脐疝发生,美容效果明显,患者及家属均较满意。结论：经脐单孔腹腔镜胆囊切除术治疗单纯胆囊结石、胆囊息肉具有术后疼痛轻、住院时间短、腹壁瘢痕隐蔽、疗效确切等优点,术中使用常规器械存在直线视野、器械干扰、麻醉手术时间明显延长、潜在风险相应增加的问题,采用常规器械行经脐单孔腹腔镜胆囊切除术基层医院宜审慎开展。
Objective ： To investigate the clinical effect, safety and feasibility of transumbilical single port laparoseopic eholecys- tectomy using conventional instruments in grass-roots hospital in the treatment of simple eholeeystolithiasis, gallbladder polyps. Meth- ods ： Retrospective analysis was made on the clinical data of 38 patients who underwent transumbilical single port laparoscopic choleeys- tectomy from Dee. 2012 to Dec. 2014. Results： Thirty-two transumbilical single port laparoscopic eholecystectomies were successful,6 cases were assisted by 5 mm incision in white line under xiphoid, no one was converted to laparotomy. Operation time was （ 73.1 ± 16.6） rain （range,50-100 rain） , blood loss was （5.7 ± 2.3 ） ml （range,2-10 ml）. No postoperative complications occurred such as bleeding, biliary leakage, bile duct injury. Patients were discharged in 3 -5 d after operation. Outpatient clinic or telephone follow-up was performed in 1,3,6,12 months after operation. 1 patient complained abdominal distention after eating,which improved after symp- tomatic treatment. 3 patients suffered from compensatory enlargement of common bile duct revealed by B ultrasound, no jaundice was found. Scars at operation incision was hidden, no umbilical hernia occurred, the cosmetic result was obvious, the patients and their fami- lies were satisfied with the results. Conclusions ： Transumbilieal single port laparoscopic cholecystectomy in the treatment of simple cho- lecystolithiasis, gallbladder polyps has advantages of little postoperative pain, short hospitalization time, hidden abdominal scar, definitely curative effect and so on, does satisfy some requirements of patients. Using conventional equipment in this procedure has some problems, for example, the linear field of view, equipment interference, prolonged anesthesia time and increased potential risk. Transumbilical single port laparoseopic choleeysteetomy with conventional instruments should be cautiously carried out in primary hospital.
出处
《腹腔镜外科杂志》
2015年第7期528-531,共4页
Journal of Laparoscopic Surgery
关键词
胆囊切除术
腹腔镜
单孔
经脐
基层医院
常规器械
Cholecystectomy, laparoscopic
Single-port
Transumbilicus
Primary hospital
Conventional instruments
