Hajong Ranendra, Hajong Debobratta, Natung Tanie, Anand Madhur, Sharma Girish
Associate Professor, Department of Surgery, NEIGRIHMS , Shillong, Meghalaya, India .
Resident Doctor, Department of Surgery, NEGRIHMS , Shillong, Meghalaya, India .
J Clin Diagn Res. 2016 Oct;10(10):PC06-PC09. doi: 10.7860/JCDR/2016/19982.8601. Epub 2016 Oct 1.
Cholelithiasis is one of the most common disorders of the digestive tract encountered by general surgeons worldwide. Conventional or open cholecystectomy was the mainstay of treatment for a long time for this disease. In the 1980s laparoscopic surgery revolutionized the management of biliary tract diseases. It brought about a revolutionary change in the basic concepts of surgical principles and minimal access surgery gradually started to be acknowledged as a safe means of carrying out surgeries.
To investigate the technical feasibility, safety and benefit of Single Incision Laparoscopic Cholecystectomy (SILC) versus Conventional Four Port Laparoscopic Cholecystectomy (C4PLC).
This prospective randomized control trial was conducted to compare the advantages if any between the SILC and C4PLC. Thirty two patients underwent SILC procedure and C4PLC, each. The age of the patients ranged from 16-60years. Other demographic data and indications for cholecystectomy were comparable in both the groups. Simple comparative statistical analysis was carried out in the present study. Results on continuous variables are shown in Mean ± SD; whereas results on categorical variables are shown in percentage (%) by keeping the level of significance at 5%. Intergroup analysis of the various study parameters was done by using Fisher exact test. SPSS version 22 was used for statistical analysis.
The mean operating time was higher in the SILC group (69 ± 4.00 mins vs. 38.53 ± 4.00 mins) which was of statistical significance (p=<0.05). Furthermore, the patients of the SILC group had less post-operative pain, with lesser analgesic requirements (p=<0.05), shorter hospital stay and earlier return to normal activity.
SILC is feasible and safe in trained hands. It did not compromise the procedural safety, or lead to any complication. The operating time was longer otherwise it has almost similar clinical outcomes to those of C4PLC.
胆结石是全球普通外科医生所遇到的最常见的消化道疾病之一。传统或开放式胆囊切除术长期以来一直是这种疾病的主要治疗方法。20世纪80年代，腹腔镜手术彻底改变了胆道疾病的治疗方式。它给手术原则的基本概念带来了革命性的变化，微创外科手术逐渐开始被公认为是一种安全的手术方式。
探讨单孔腹腔镜胆囊切除术（SILC）与传统四孔腹腔镜胆囊切除术（C4PLC）的技术可行性、安全性和益处。
进行这项前瞻性随机对照试验以比较SILC和C4PLC之间的优势（如有）。每组各有32例患者接受SILC手术和C4PLC手术。患者年龄在16至60岁之间。两组的其他人口统计学数据和胆囊切除术的指征具有可比性。本研究进行了简单的比较统计分析。连续变量的结果以均值±标准差表示；而分类变量的结果以百分比（%）表示，显著性水平设定为5%。使用Fisher精确检验对各种研究参数进行组间分析。采用SPSS 22版进行统计分析。
SILC组的平均手术时间较长（69±4.00分钟对38.53±4.00分钟），具有统计学意义（p<0.05）。此外，SILC组患者术后疼痛较轻，镇痛需求较少（p<0.05），住院时间较短，恢复正常活动较早。
在技术熟练的医生手中，SILC是可行且安全的。它没有损害手术安全性，也没有导致任何并发症。手术时间较长，否则其临床结果与C4PLC几乎相似。
