Luo Cheng-yu, Ji Xiao-xin, Zhang Jian, Yang Qi
Affiliated Beijing Fuxing Hospital, Capital University of Medical Science, Beijing 100038, China.
Zhonghua Wai Ke Za Zhi. 2011 May 1;49(5):424-7.
To study the feasibility and safety of transumbilical single incision laparoscopic cholecystectomy.
Eighty-two cases with gallbladder diseases were underwent with transumbilical single incision laparoscopic cholecystectomy. Some difficulties and countermeasure in operations were analyzed.
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.
Transumbilical single incision laparoscopic cholecystectomy is safe and feasible. The difficulties in technique are easy to be broken through.
探讨经脐单孔腹腔镜胆囊切除术的可行性及安全性。
对82例胆囊疾病患者施行经脐单孔腹腔镜胆囊切除术，分析手术中的一些困难及对策。
全部患者中9例因胆囊周围炎症、Calot三角解剖困难及胆囊动脉变异中转手术，其中6例中转至两孔法腹腔镜胆囊切除术，3例中转至开腹手术。其余73例成功施行经脐单孔腹腔镜胆囊切除术，成功率为89.0%。平均手术时间为48.4分钟，平均术中出血量为20.8毫升。患者术后第一天恢复流食，住院时间为3至6天。随访13.7个月期间，无胆管损伤、大出血、切口感染、胆瘘及脐疝发生，切口愈合良好，脐部瘢痕隐蔽不易观察到。
经脐单孔腹腔镜胆囊切除术安全可行，技术难点易于突破。
