Franklin Morris E, Jaramillo Eduardo J, Glass Jeffrey L, Treviño Jorge M, Berghoff Keenan R
Texas Endosurgery Institute, San Antonio, Texas 78222, USA.
JSLS. 2006 Jan-Mar;10(1):43-6.
Needlescopic cholecystectomy (NC) is a refinement of laparoscopic cholecystectomy (LC) using 2-mm instruments compared with the standard 5-mm and 10-mm ports. We review our experience with needlescopic cholecystectomy.
From 1994 to 2004, 303 patients underwent NC. All patients were operated on using 2-mm instruments and one 10-mm trocar for the laparoscope. The characteristics of patients, total operation time, complications, postoperative pain, and hospital course were documented.
Patients' average age was 41.86 years; 262 were female and 41 were male. Mean BMI was 25.7. Mean length of surgery was 59.33 minutes. Intraoperative cholangiography was performed in all cases. Mean blood loss was 14.88 mL. One intraoperative complication occurred. Mean hospital stay was 22.68 hours. Postoperative pain was measured on a 0-10 pain scale; on day 0 it was 4.4 and on the first day it was 1.7. Analgesic doses required were 0 doses in 6.89%, 1 in 20.68%, 2 in 24.13%, 3 in 34.48%, 4 in 13.79%, and > 4 doses was not required. No postoperative complications occurred. At 3-month follow-up, patient satisfaction was 100%, and in 99% of patients scars were imperceptible.
NC is safe and feasible without increased operative risk, with better cosmetic results, less pain, and good acceptance among patients.
针状腹腔镜胆囊切除术（NC）是腹腔镜胆囊切除术（LC）的一种改进术式，与标准的5毫米和10毫米端口相比，它使用2毫米器械。我们回顾了我们针状腹腔镜胆囊切除术的经验。
1994年至2004年，303例患者接受了NC手术。所有患者均使用2毫米器械及一个用于腹腔镜的10毫米套管针进行手术。记录患者的特征、总手术时间、并发症、术后疼痛及住院过程。
患者平均年龄为41.86岁；女性262例，男性41例。平均体重指数为25.7。平均手术时长为59.33分钟。所有病例均进行了术中胆管造影。平均失血量为14.88毫升。发生了1例术中并发症。平均住院时间为22.68小时。术后疼痛采用0至10分疼痛量表进行测量；术后第0天为4.4分，第一天为1.7分。所需镇痛剂量为：6.89%的患者无需用药，20.68%的患者用药1次，24.13%的患者用药2次，34.48%的患者用药3次，13.79%的患者用药4次，无需超过4次用药。未发生术后并发症。在3个月的随访中，患者满意度为100%，99%的患者瘢痕不可察觉。
针状腹腔镜胆囊切除术安全可行，不会增加手术风险，具有更好的美容效果、更少的疼痛，且患者接受度良好。
