Surg Endosc. 2010 Sep;24(9):2241-7. doi: 10.1007/s00464-010-0943-z. Epub 2010 Mar 3.
Single-incision laparoscopic surgery (SILS) is a new advance wherein laparoscopic surgery is carried out through a single small incision hidden in the umbilicus. Advantages of this technique over standard laparoscopy are still under investigation. The objective of this study is to describe the short-term outcomes of SILS cholecystectomy in a single community-based institution.
A retrospective review of a prospectively collected database for all patients who underwent SILS cholecystectomy was carried out. Both true single-incision and dual-incision (training) cases were included in the analysis. Operative and perioperative outcomes were analyzed.
Eighty SILS cholecystectomies (4 dual incision and 76 single incision) were performed from May 30, 2008 to April 23, 2009 (indications: 48 stones, 20 cholecystitis, 11 biliary dyskinesia, and 1 polyp). Mean body mass index (BMI) was 26.5 kg/m(2) (range 17.3-39.1 kg/m(2)), mean operating room (OR) time was 69.5 min (range 29-126 min), mean estimated blood loss (EBL) was 5 cc, and mean incision length was 1.6 cm. There were no open conversions, but there were six conversions to dual-port and three conversions to four-port laparoscopic cholecystectomy due to poor visualization. Complications include three bile leaks managed with endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous drainage (3.7%). Two leaks were from accessory ducts and one was from a cystic duct stump. Number of days of postoperative oral narcotic use was described as none in 11 patients (23%), minimal (1 day) in 21 patients (45%), moderate (1-3 days) in 6 patients (13%), and heavy (≥ 4 days) in 9 patients (19%), with mean follow-up of 4.7 months in 60 patients.
SILS cholecystectomy is feasible, with acceptable morbidity. Although not directly compared in this study, postoperative recovery appears shorter than after standard laparoscopy, but more studies are needed.
单切口腹腔镜手术（SILS）是一种新的进展，通过隐藏在脐部的单个小切口进行腹腔镜手术。该技术相对于标准腹腔镜的优势仍在研究中。本研究的目的是描述单一社区机构中 SILS 胆囊切除术的短期结果。
对所有接受 SILS 胆囊切除术的患者进行前瞻性收集数据库的回顾性分析。包括真正的单切口和双切口（培训）病例。分析手术和围手术期结果。
2008 年 5 月 30 日至 2009 年 4 月 23 日，共进行了 80 例 SILS 胆囊切除术（4 例双切口和 76 例单切口）（适应证：48 例结石，20 例胆囊炎，11 例胆动障碍，1 例息肉）。平均体重指数（BMI）为 26.5kg/m²（范围 17.3-39.1kg/m²），平均手术室（OR）时间为 69.5 分钟（范围 29-126 分钟），平均估计失血量（EBL）为 5cc，平均切口长度为 1.6cm。没有开放转换，但由于可视化效果不佳，有 6 例转为双端口和 3 例转为四端口腹腔镜胆囊切除术。并发症包括 3 例胆漏，经内镜逆行胰胆管造影（ERCP）和经皮引流（3.7%）处理。2 例漏出物来自副胆管，1 例来自胆囊管残端。术后口服麻醉药的天数描述为 11 例（23%）无，21 例（45%）最少（1 天），6 例（13%）中度（1-3 天），9 例（19%）重度（≥4 天），60 例患者的平均随访时间为 4.7 个月。
SILS 胆囊切除术是可行的，发病率可接受。虽然在本研究中没有直接比较，但术后恢复似乎比标准腹腔镜短，但还需要更多的研究。
