Raakow Roland, Jacob Dietmar A
Department of Surgery, Vivantes Hospital Am Urban, Dieffenbachstrasse 1, 10967 Berlin, Germany.
Minim Invasive Surg. 2011;2011:915735. doi: 10.1155/2011/915735. Epub 2011 Jul 2.
Background and Aims. We describe our experience of performing transumbilical single-incision laparoendoscopic cholecystectomy as standard procedure for acute and chronic gallbladder diseases. Methods. Between September 2008 and March 2010, 220 patients underwent laparoscopic single-incision surgery. A single port was used for 196 patients and two conventional 5 mm and one 10 mm port in 24 cases. All operations were performed with straight instruments. Results. Single-incision surgery was successfully performed in 215 patients (98%). Three patients (1.4%) required conversion to a three-port technique and two patients (0.9%) to an open procedure. Average age of 142 women (65%) and 78 men (35%) was 47 years (range: 15-89), average ASA status 2 (range: 1-3) and BMI 28 (range: 15-49). Mean operative time was 62 minutes (range: 26-174) and 57 patients (26%) had histopathological signs of acute cholecystitis. Eleven patients (5%) developed to surgery-related complications and nine (4%) of these required a reoperation. The mean followup was 331.5 (range: 11-590) days. Conclusion. Transumbilical single-incision cholecystectomy is a feasible and safe new approach for routine cholecystectomy. After a short learning curve, operation time and complication rate are comparable with standard multiport operation. In addition, most cases of acute cholecystitis can be performed with this technique.
背景与目的。我们描述了将经脐单孔腹腔镜胆囊切除术作为急性和慢性胆囊疾病标准手术的经验。方法。2008年9月至2010年3月期间，220例患者接受了腹腔镜单孔手术。196例患者使用单个端口，24例患者使用两个传统的5毫米端口和一个10毫米端口。所有手术均使用直器械进行。结果。215例患者（98%）成功完成单孔手术。3例患者（1.4%）需要转换为三孔技术，2例患者（0.9%）需要转换为开放手术。142例女性（65%）和78例男性（35%）的平均年龄为47岁（范围：15 - 89岁），平均美国麻醉医师协会（ASA）分级为2级（范围：1 - 3级），体重指数（BMI）为28（范围：15 - 49）。平均手术时间为62分钟（范围：26 - 174分钟），57例患者（26%）有急性胆囊炎的组织病理学征象。11例患者（5%）发生了与手术相关的并发症，其中9例（4%）需要再次手术。平均随访时间为331.5天（范围：11 - 590天）。结论。经脐单孔胆囊切除术是一种可行且安全的常规胆囊切除新方法。经过短暂的学习曲线后，手术时间和并发症发生率与标准多孔手术相当。此外，大多数急性胆囊炎病例可以用这种技术进行手术。
