Tian Ming G, Zhang Pei J, Yang Y, Shang Fan J, Zhan J
Department of Hepatobiliary Surgery, the People's Hospital of Ningxia Autonomous Region, Yinchuan, Ningxia, China.
J Minim Access Surg. 2013 Jul;9(3):122-5. doi: 10.4103/0972-9941.115372.
Although transumbilical single incision laparoscopic cholecystectomy (SILC) has been demonstrated to be superior cosmetic, it is only limited to simple cases at present. In complex cases, the standard four- or three-port LC is still the treatment of choice.
To summarize the clinical effect of a modified technique in two-port LC.
A consecutive series of patients with benign gallbladder diseases admitted to the provincial teaching hospital who underwent LC in the past 4 years were included. A modified two-port LC was the first choice except for those requiring laparoscopic common bile duct exploration (LCBDE).
The operation was done with suture retraction of the fundus by a needle-like retractor. The patients' data, including the operative time, time consumed by gallbladder retraction, operative bleeding, conversion rate, rate of adding trocars, and postoperative complications were recorded.
Data were expressed as percentage and mean with standard deviation.
Total 107 patients with chronic calculous cholecystitis (N = 61), acute calculous cholecystitis (N = 43), and cholecystic polyps (N = 3) received two-port LC. The procedure was successful in 99 out of 107 cases (success rate, 92.5%), and a third trocar was added in the remaining 8 cases (7.5%) due to severe pathological changes. The operative time was 47.2 (±13.21) min. There was no conversion to open surgery.
Two-port LC using a needle-like retractor for suture retraction of the gallbladder fundus is a practical approach when considering the safety, convenience, and indications as well as relatively minimal invasion.
尽管经脐单孔腹腔镜胆囊切除术（SILC）已被证明具有更好的美容效果，但目前仅适用于简单病例。在复杂病例中，标准的四孔或三孔腹腔镜胆囊切除术（LC）仍是首选治疗方法。
总结改良双孔LC的临床效果。
纳入在过去4年中入住省级教学医院并接受LC的一系列连续性良性胆囊疾病患者。除了那些需要腹腔镜胆总管探查（LCBDE）的患者外，改良双孔LC是首选方法。
使用针状牵开器通过缝线牵拉胆囊底部进行手术。记录患者的数据，包括手术时间、胆囊牵拉时间、术中出血、中转率、增加套管针的比例以及术后并发症。
数据以百分比和均值±标准差表示。
共有107例慢性结石性胆囊炎患者（n = 61）、急性结石性胆囊炎患者（n = 43）和胆囊息肉患者（n = 3）接受了双孔LC。107例患者中有99例手术成功（成功率92.5%），其余8例（7.5%）因病变严重增加了第三套管针。手术时间为47.2（±13.21）分钟。无中转开腹手术。
使用针状牵开器通过缝线牵拉胆囊底部的双孔LC，在安全性、便利性、适应证以及相对较小的侵袭性方面是一种实用的方法。
