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采用“双孔”技术的单切口腹腔镜胆囊切除术安全可行:101例连续患者的经验

Single incision laparoscopic cholecystectomy using a "two-port" technique is safe and feasible: experience in 101 consecutive patients.

作者信息

Rupp Christopher C, Farrell Timothy M, Meyer Anthony A

机构信息

Division of Gastrointestinal Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

出版信息

Am Surg. 2011 Jul;77(7):916-21.

Abstract

Single incision laparoscopic cholecystectomy (SILC) is a new minimally-invasive technique that has recently been developed to address several disease processes of the gallbladder. However, the safety and feasibility of this technique are still being evaluated. Utilizing a "two-port" technique with transabdominal suture retraction and a rigorous adherence to the critical view of safety, we evaluated our experience in a prospectively maintained database and compared this with standard laparoscopic cholecystectomy (SLC) over the same period. SILC was completed successfully in 87 per cent of patients. Operative times were found to be similar between SLC and SILC (75 and 76 minutes, respectively; P = 0.12). Operative blood loss, hospital stay, and short-term complications were not statistically different between SILC and SLC. Cholangiograms, obtained on a selective basis, were performed in 19 per cent of SILCs. No bile duct injuries occurred during SILC or SLC. Although our aggregate number is not enough to accurately assess the rate or safety of bile duct injuries, SILC seems to be safe and feasible when evaluating other metrics and does not seem to interfere with operative efficiency compared with SLC.

摘要

单孔腹腔镜胆囊切除术(SILC)是一种新的微创技术,最近已被开发用于处理胆囊的多种疾病过程。然而,该技术的安全性和可行性仍在评估中。我们采用经腹缝线牵拉的“双孔”技术并严格遵循关键安全视野,在一个前瞻性维护的数据库中评估了我们的经验,并将其与同期的标准腹腔镜胆囊切除术(SLC)进行了比较。87%的患者成功完成了SILC。发现SLC和SILC的手术时间相似(分别为75分钟和76分钟;P = 0.12)。SILC和SLC之间的术中失血、住院时间和短期并发症无统计学差异。在19%的SILC手术中选择性地进行了胆管造影。SILC或SLC期间均未发生胆管损伤。虽然我们的总数不足以准确评估胆管损伤的发生率或安全性,但在评估其他指标时,SILC似乎是安全可行的,并且与SLC相比似乎不会干扰手术效率。

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