CAJ | 학술논문

目的尝试应用脐周三套管技术实现腹壁完全无可见瘢痕的经脐入路腹腔镜胆囊切除术.方法 64例胆囊疾病(胆囊息肉13例,胆石症51例)患者行经脐入路腹腔镜胆囊切除术.沿脐周呈倒三角形置入2只经改进的直径为5 mm的操作套管和1只普通的直径为5 mm的套管.分别置入5 mm腹腔镜和加长的操作器械完成经脐入路胆囊切除.结果 62例患者顺利完成经脐入路胆囊切除术.2例因操作困难,术中见解剖结构不清而中转行常规腹腔镜手术.手术时间为25～65 min,平均为(36±32)min.所选患者均未放置引流管.术后除脐部皱折部位外,基本无可见的腹壁瘢痕,且无出血、胆漏等并发症发生.结论应用脐周三套管技术行经脐入路腹腔镜胆囊切除术可以减少脐周各操作器械之间发生的外部冲突,使该技术的操作难度大为降低.
목적 상시응용제주삼투관기술실현복벽완전무가견반흔적경제입로복강경담낭절제술.방법 64례담낭질병(담낭식육13례,담석증51례)환자행경제입로복강경담낭절제술.연제주정도삼각형치입2지경개진적직경위5 mm적조작투관화1지보통적직경위5 mm적투관.분별치입5 mm복강경화가장적조작기계완성경제입로담낭절제.결과 62례환자순리완성경제입로담낭절제술.2례인조작곤난,술중견해부결구불청이중전행상규복강경수술.수술시간위25～65 min,평균위(36±32)min.소선환자균미방치인류관.술후제제부추절부위외,기본무가견적복벽반흔,차무출혈、담루등병발증발생.결론 응용제주삼투관기술행경제입로복강경담낭절제술가이감소제주각조작기계지간발생적외부충돌,사해기술적조작난도대위강저.
Objective To use peri-umbilical three trocar technique for scar-free transumbilical laparoscopic cholecystectomy. Methods Transumbilical laparoscopic cholecystectomy was performed in patients with gallbladder polyps (13 cases) and gallstones (51 cases). Three 5 mm trocars (including two improved trocars and one conventionally trocar) were introduced into the abdomen transumbilically. Results The gallbladders were successfully removed in all patients without intra- or post-operative bleeding or bile leakage, except that two technically difficult cases were converted to conventional laparoscopic surgery. The mean operating time was 25-65 min in our group, averaging (36±32) min. All the patients were satisfied with the abdominal cosmetic results. Conclusions The external interference between trocars and instruments can be partially avoided by using the title technique. Total transumbilical laparoscopic cholecystectomy is made feasible by this technique.