CAJ | 학술논문

目的研究经脐单孔腹腔镜胆囊切除术临床可行性及安全性.方法总结2009年2月至2010年12月、82例胆囊疾病患者实施经脐单孔腹腔镜胆囊切除术的经验,并分析手术中碰到的一些疑难问题和应对策略.结果 82例患者中,9例患者由于胆囊周围炎症、胆囊三角解剖困难及胆囊动脉结构变异等原因改行其他术式,其中6例改行二孔法腹腔镜胆囊切除术,3例中转常规开放性手术;其余73例手术均顺利完成单孔手术,成功率89.0%.手术时间平均48.4 min,手术出血平均20.8 ml.术后次日恢复流质饮食,住院3～6 d.术后平均随访13.7个月,均无胆管损伤、大出血、切口感染、胆漏、脐疝等并发症发生,术后复查切口愈合良好,瘢痕极隐蔽而不易察觉.结论经脐单孔腹腔镜胆囊切除是安全可行的,技术上的难点容易突破.
목적 연구경제단공복강경담낭절제술림상가행성급안전성.방법 총결2009년2월지2010년12월、82례담낭질병환자실시경제단공복강경담낭절제술적경험,병분석수술중팽도적일사의난문제화응대책략.결과 82례환자중,9례환자유우담낭주위염증、담낭삼각해부곤난급담낭동맥결구변이등원인개행기타술식,기중6례개행이공법복강경담낭절제술,3례중전상규개방성수술;기여73례수술균순리완성단공수술,성공솔89.0%.수술시간평균48.4 min,수술출혈평균20.8 ml.술후차일회복류질음식,주원3～6 d.술후평균수방13.7개월,균무담관손상、대출혈、절구감염、담루、제산등병발증발생,술후복사절구유합량호,반흔겁은폐이불역찰각.결론 경제단공복강경담낭절제시안전가행적,기술상적난점용역돌파.
Objective To study the feasibility and safety of transumbilical single incision laparoscopic cholecystectomy. Methods Eighty-two cases with gallbladder diseases were underwent with transumbilical single incision laparoscopic cholecystectomy. Some difficulties and countermeasure in operations were analyzed. Results Nine in all patients were converted because of the surrounding inflammation of gallbladder, difficult to dissect in Calot's triangulation and variation of gallbladder artery. Of them, 6 cases converted to two-hole laparoscopic cholecystectomy and 3 cases to open operation. Other 73 cases were successfully operated with transumbilical single incision laparoscopic cholecystectomy. The success rate was 89. 0%. The average operative duration was 48.4 min. The average operative blood loss was 20. 8 ml. Patients returned to liquid food on the first day after operation. Hospital duration was 3～6 d. During 13.7 months of follow-up, there was no bile duct injury, large bleeding, incision infection, bile fistula and umbilical hernia. The incision healed well. The scar in umbilicus was concealing and difficult to be observed. Conclusions Transumbilical single incision laparoscopic cholecystectomy is safe and feasible. The difficulties in technique are easy to be broken through.