中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
6期
460-462
,共3页
李宏%万世泽%俞丹松%芦曙辉%毛海香%周新华%王韡%李根丛
李宏%萬世澤%俞丹鬆%蘆曙輝%毛海香%週新華%王韡%李根叢
리굉%만세택%유단송%호서휘%모해향%주신화%왕위%리근총
胆囊切除术,腹腔镜%单切口%钛夹
膽囊切除術,腹腔鏡%單切口%鈦夾
담낭절제술,복강경%단절구%태협
Cholecystectomy,laparoscopic%Single-incision%Titanium clips
目的 探讨单切口免钛夹腹腔镜胆囊切除术治疗胆囊良性疾病的可行性及安全性.方法 按患者意愿对1890例胆囊良性疾病患者中的1016例采用脐部单切口免钛夹腹腔镜胆囊切除术(单切口组),实际完成1001例,与同期完成的874例两孔法免钛夹腹腔镜胆囊切除术患者进行比较,采用t检验和x2比较两组的手术时间、术中出血量、术后恢复等情况.结果 单切口组1016例仅15例因胆囊壶腹部炎症严重改为传统的四孔法切除,其余1001例均顺利完成单切口下LC术.两孔法组完成腹腔镜胆囊切除术874例.两组均无胆漏、胆道损伤及手术死亡等严重的手术并发症.单切口组与两孔法组的手术时间无差异[(34.5±5.2)min与(32.0±7.4)min,t=0.063,P=0.526]、术中出血量无差异[(56.5±17.8) ml与(55.2±15.9)ml,t=0.812,P=0.425]、术后住院时间无差异[(3.1±0.8)d与(3.2±O.7)d,t=1.073,P=0.326],而单切口组切口疼痛轻于两孔法组(P=0.000).结论 单切口免钛夹腹腔镜胆囊切除术安全性好,创伤更小,更美观.[关健词]胆囊切除术,腹腔镜;单切口;钛夹
目的 探討單切口免鈦夾腹腔鏡膽囊切除術治療膽囊良性疾病的可行性及安全性.方法 按患者意願對1890例膽囊良性疾病患者中的1016例採用臍部單切口免鈦夾腹腔鏡膽囊切除術(單切口組),實際完成1001例,與同期完成的874例兩孔法免鈦夾腹腔鏡膽囊切除術患者進行比較,採用t檢驗和x2比較兩組的手術時間、術中齣血量、術後恢複等情況.結果 單切口組1016例僅15例因膽囊壺腹部炎癥嚴重改為傳統的四孔法切除,其餘1001例均順利完成單切口下LC術.兩孔法組完成腹腔鏡膽囊切除術874例.兩組均無膽漏、膽道損傷及手術死亡等嚴重的手術併髮癥.單切口組與兩孔法組的手術時間無差異[(34.5±5.2)min與(32.0±7.4)min,t=0.063,P=0.526]、術中齣血量無差異[(56.5±17.8) ml與(55.2±15.9)ml,t=0.812,P=0.425]、術後住院時間無差異[(3.1±0.8)d與(3.2±O.7)d,t=1.073,P=0.326],而單切口組切口疼痛輕于兩孔法組(P=0.000).結論 單切口免鈦夾腹腔鏡膽囊切除術安全性好,創傷更小,更美觀.[關健詞]膽囊切除術,腹腔鏡;單切口;鈦夾
목적 탐토단절구면태협복강경담낭절제술치료담낭량성질병적가행성급안전성.방법 안환자의원대1890례담낭량성질병환자중적1016례채용제부단절구면태협복강경담낭절제술(단절구조),실제완성1001례,여동기완성적874례량공법면태협복강경담낭절제술환자진행비교,채용t검험화x2비교량조적수술시간、술중출혈량、술후회복등정황.결과 단절구조1016례부15례인담낭호복부염증엄중개위전통적사공법절제,기여1001례균순리완성단절구하LC술.량공법조완성복강경담낭절제술874례.량조균무담루、담도손상급수술사망등엄중적수술병발증.단절구조여량공법조적수술시간무차이[(34.5±5.2)min여(32.0±7.4)min,t=0.063,P=0.526]、술중출혈량무차이[(56.5±17.8) ml여(55.2±15.9)ml,t=0.812,P=0.425]、술후주원시간무차이[(3.1±0.8)d여(3.2±O.7)d,t=1.073,P=0.326],이단절구조절구동통경우량공법조(P=0.000).결론 단절구면태협복강경담낭절제술안전성호,창상경소,경미관.[관건사]담낭절제술,복강경;단절구;태협
Objective To explore the safety and feasibility of single-incision laparoscopic cholecystectomy without using titanium-clips. Methods Data of 1016 patients(group A) undergoing single-incision laparoscopic cholecystectomy without using titanium-clips were compared to that of 874 patients(group B)undergoing two-port laparoscopic cholecystectomy without using titanium-clips by t test and chi square test for operating time,operative hemorrhage,the length of postoperative hospital stay and postoperative pain.Results In group A,1001 cases were successfully operated on with single-incision laparoscopic cholecystectomy,with conversion to classic four-port laparoscopic cholecystectomy in 15 cases,while 874 cases in group B were operated on with two-port laparoscopic cholecystectomy.There were no bile leakage,biliary tract injury or death in both groups.There were no difference in operating time[(34.5 ±5.2) min vs (32.0±7.4)min,t=0.063,P=0.526],the length of postoperative hospital stay[(3.1±0.8)d vs(3.2±0.7)d,t=1.073,P=0.326]and operative hemorrhage[(56.5±17.8)ml vs (55.2±15.9)ml,t=0.812,P=0.425](P>0.05) between the two groups,but the postoperative pain was less severe in Group A than that in group B (P=0.000<0.05). Conclusions The single-incision laparoscopic cholecystectomy is feasible,safe,less traumatic and more cosmetic.
