Wu Shuodong, Lv Chao, Tian Yu, Fan Ying, Yu Hong, Kong Jing, Li Yongnan, Yu Xiaopeng, Yao Dianbo, Chen Yongsheng, Han Jinyan
Biliary Unit, Department of General Surgery, Shengjing Hospital of China Medical University, Sanhao Street 36#, Shenyang, The People's Republic of China.
Surg Endosc. 2016 Aug;30(8):3375-85. doi: 10.1007/s00464-015-4618-7. Epub 2015 Nov 3.
Currently, researches about single-incision laparoscopic cholecystectomy (SILC) are various, but long-term reviews assessing relevant complications after SILC with considerable amount of case series are rare.
We retrospectively reviewed a large series of 529 patients undergoing SILC to assess the long-term postoperative recovery, including postoperative complications, retained symptoms, and quality of life. Finally, we assessed its associated risk factors related to SILC patients' recovery in the long term.
During a mean follow-up period of 36.8 ± 8.8 months after SILC, 402 (76.0 %) patients underwent complete resolution. Frequent diarrhea (12.1 %) and recurrent omphalitis (5.9 %) were most commonly seen among other complications and retained symptoms within overall the patients. We identified 1 (0.3 %) incision hernia and 1 (0.3 %) intra-abdominal abscess among overall the patients, while 3 (0.8 %) common bile duct stones and 1 (0.3 %) biliary pancreatitis among the patients with symptomatic cholelithiasis during long-term review period. No significant differences were identified between patients with symptomatic cholelithiasis and gallbladder polyps when considering other incidences (all p > 0.05). Patients undergoing SILC with older age (p = 0.023) or female gender (p = 0.020) contributed to complete resolution.
SILC via traditional devices is feasible and safe with acceptable postoperative incidence rate in the long run. Patients with older age or female gender, who have no severe systemic diseases, tend to benefit more from the surgical intervention.
目前,关于单孔腹腔镜胆囊切除术(SILC)的研究多种多样,但对大量病例系列进行SILC术后相关并发症的长期评估却很少见。
我们回顾性分析了529例行SILC的患者的大样本队列,以评估术后长期恢复情况,包括术后并发症、残留症状和生活质量。最后,我们评估了与SILC患者长期恢复相关的危险因素。
在SILC术后平均随访36.8±8.8个月期间,402例(76.0%)患者完全康复。在所有患者的其他并发症和残留症状中,最常见的是频繁腹泻(12.1%)和复发性脐炎(5.9%)。在所有患者中,我们发现1例(0.3%)切口疝和1例(0.3%)腹腔内脓肿,而在长期随访期间,有症状胆石症患者中发现3例(0.8%)胆总管结石和1例(0.3%)胆源性胰腺炎。在考虑其他发生率时,有症状胆石症患者和胆囊息肉患者之间未发现显著差异(所有p>0.05)。年龄较大(p=0.023)或女性(p=0.020)的患者行SILC有助于完全康复。
从长远来看,通过传统器械进行SILC是可行且安全的,术后发生率可接受。年龄较大或女性且无严重全身性疾病的患者往往从手术干预中获益更多。