单孔腹腔镜胆囊切除术（SILC）：一种改良技术。
Single-incision laparoscopic cholecystectomy (SILC): a refined technique.
机构信息
Department of Minimally Invasive Surgery, St John Hospital and Medical Center, Detroit, MI, USA.
出版信息
Am J Surg. 2010 Mar;199(3):289-93; discussion 293. doi: 10.1016/j.amjsurg.2009.08.037.
BACKGROUND
Reports of decreasing the number of incisions in laparoscopic procedures began appearing in the 1990s. A recent spark in pursuing such an approach has been accelerated by natural-orifice transluminal endoscopic surgery.
METHOD
Several modifications in performing single-incision laparoscopic cholecystectomy (SILC) were introduced until it was possible to develop a simple and safe technique.
RESULTS
SILC was completed in 61 of 71 operated patients. Fifty-five patients had SILC without cholangiography (average operative time, 49 minutes). Thirteen patients had SILC with cholangiography, 11 with negative results (average operative time, 67 minutes). Three patients needed additional trocars (bi-incision access surgery [BIAS]). None were converted to open procedures. Of the 69 patients with SILC or BIAS, 66 had same-day discharge, and 3 were discharged the following day.
CONCLUSION
SILC or BIAS is effective for gallbladder removal, with comparable lengths of stay, operative times, and safety as the traditional method, with better cosmetic results.
背景
早在 20 世纪 90 年代，就有报道称腹腔镜手术的切口数量在减少。最近，由于经自然腔道内镜外科手术的出现，人们对这种方法的追求更加积极。
方法
在实施单切口腹腔镜胆囊切除术（SILC）的过程中，我们引入了几种改进方法，直到开发出一种简单而安全的技术。
结果
在 71 例接受手术的患者中，有 61 例完成了 SILC。55 例患者未行胆管造影即行 SILC（平均手术时间为 49 分钟）。13 例患者行 SILC 并进行胆管造影，其中 11 例结果为阴性（平均手术时间为 67 分钟）。3 例患者需要额外的 trocars（双切口入路手术[BIAS]）。无中转开腹手术。在 69 例接受 SILC 或 BIAS 的患者中，有 66 例患者于当天出院，3 例患者于次日出院。
结论
SILC 或 BIAS 可有效切除胆囊，与传统方法相比，其住院时间、手术时间和安全性相当，且美容效果更好。
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