Ryu Yun Beom, Lee Jung Woo, Park Yo Han, Lim Man Sup, Cho Ji Woong, Jeon Jang Yong
Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Department of Surgery, Inje University Busan Paik Hospital, Busan, Korea.
Ann Surg Treat Res. 2016 Feb;90(2):72-8. doi: 10.4174/astr.2016.90.2.72. Epub 2015 Jan 28.
Single incision laparoscopic cholecystectomy (SILC) is generally performed with the use of inverse triangulation. In this study, we performed 3-channel or 4-channel SILC without the use of inverse triangulation. We evaluated the adequacy and feasibility of SILC using our surgical method.
We retrospectively reviewed our series of 309 SILCs performed between March 2014 and February 2015.
Among 309 SILCs, male were 148 and female were 161 patients, mean age was 48.7 ± 15.3 years old and mean body mass index was 24.8 ± 3.8 kg/m(2). Forty patients had previously undergone abdominal surgery including 6 cases of upper abdominal surgery. SILC after percutaneous transhepatic gallbladder (GB) drainage was completed in 8.7% of cases. There were 10 cases of emergency SILC. SILC was performed for noncomplicated GB including symptomatic GB stone and polyp in 66.7% of cases, acute cholecystitis in 33.3%. Overall, 96.8% of procedures were successfully completed without additional port. The reason for addition of an extra port or open conversion included technical difficulties due to severe adhesion and bleeding. The mean operating time was 60.7 ± 22.3 minutes. The overall complication rate was 4.8%: 9 patients of wound seroma, 1 case of bile leakage from GB bed, 4 cases of intra-abdominal abscess or fluid collection, and 1 case of incisional hernia were developed. There was no case of common bile duct injury.
Our surgical method of SILC without the use of inverse triangulation is safe, feasible and effective technique.
单孔腹腔镜胆囊切除术（SILC）通常采用反向三角定位法进行。在本研究中，我们在不使用反向三角定位法的情况下进行了三通道或四通道SILC。我们评估了使用我们的手术方法进行SILC的充分性和可行性。
我们回顾性分析了2014年3月至2015年2月期间进行的309例SILC病例。
在309例SILC中，男性148例，女性161例，平均年龄为48.7±15.3岁，平均体重指数为24.8±3.8kg/m²。40例患者既往接受过腹部手术，其中6例为上腹部手术。8.7%的病例在经皮经肝胆囊引流术后完成了SILC。有10例急诊SILC。66.7%的病例为非复杂性胆囊疾病，包括有症状的胆囊结石和息肉，33.3%为急性胆囊炎。总体而言，96.8%的手术在未增加额外端口的情况下成功完成。增加额外端口或转为开放手术的原因包括严重粘连和出血导致的技术困难。平均手术时间为60.7±22.3分钟。总体并发症发生率为4.8%：9例伤口血清肿，1例胆囊床胆汁漏，4例腹腔内脓肿或积液，1例切口疝。无胆总管损伤病例。
我们不使用反向三角定位法的SILC手术方法是一种安全、可行且有效的技术。
