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使用传统器械和端口的单切口腹腔镜胆囊切除术:三级医疗公共部门医院的初步经验。

Single incision laparoscopic cholecystectomy with conventional instruments and ports: Initial experience at tertiary care public sector Hospital.

作者信息

Shaikh Abdul Razaque, Ali Syed Asad, Munir Ambreen, Shaikh Aijaz Ali

机构信息

Abdul Razaque Shaikh, Professor & Dean Surgery Department of Surgery, Liaquat University of Medical &Health Sciences, Jamshoro, Sindh, Pakistan.

Syed Asad Ali Associate Professor, Department of Surgery, Liaquat University of Medical &Health Sciences, Jamshoro, Sindh, Pakistan.

出版信息

Pak J Med Sci. 2017 May-Jun;33(3):654-658. doi: 10.12669/pjms.333.12930.

Abstract

OBJECTIVE

To find out safety and feasibility of single incision laparoscopic cholecystectomy (SLIC) using conventional instruments.

METHODS

This study was conducted at surgical department of LUMHS Jamshoro Pakistan from Jan: 2014 to Dec: 2015. All cases of symptomatic cholelithiasis that consented for laparoscopic surgery were included. The exclusion criteria were acute cholecystitis, acute gall stone pancreatitis, common bile duct stones and patients with co-morbid. A midline 3cm incision made supraumbilically and 10mm port placed. Two 5mm ports placed on either side of umbilicus slightly superior and laterally in or-der to triangulate. A 2/0 prolene suture placed through the infundibulum of the gall bladder to achieve retraction. The rest of the procedure is like standard 4 ports laparoscopic cholecystectomy.

RESULTS

Total no of cases were 50. The age ranged from 30-59 years (mean 35.20 years ±4.886.) There were 43(86%) females and 07(14%) males. The mean operating time was 80 minutes (range 50-120 ±16.020). Four (8%) cases were converted to standard four ports laparoscopic cholecystectomy due to bleeding and difficult dissection in Calot's triangle. Minimal blood loss was observed during the procedure with no postoperative complications. The range of hospital stay was 1-2 days (mean 1.08 ±0.274).

CONCLUSION

SILC is a safe and feasible procedure with conventional laparoscopic instruments without additional cost of single port and articulated instruments. The cosmetic results are excellent with minimal increase in the operating time.

摘要

目的

探讨使用传统器械进行单孔腹腔镜胆囊切除术(SLIC)的安全性和可行性。

方法

本研究于2014年1月至2015年12月在巴基斯坦詹姆肖罗市利亚夸特大学医学与健康科学学院外科进行。纳入所有同意接受腹腔镜手术的有症状胆结石病例。排除标准为急性胆囊炎、急性胆石性胰腺炎、胆总管结石及合并其他疾病的患者。在脐上做一个3cm的中线切口,置入10mm的端口。在脐两侧稍上方和外侧各置入一个5mm的端口,以形成三角定位。通过胆囊漏斗置入一根2/0的普理灵缝线以实现牵拉。其余操作与标准四孔腹腔镜胆囊切除术相同。

结果

病例总数为50例。年龄范围为30 - 59岁(平均35.20岁±4.886)。女性43例(86%),男性7例(14%)。平均手术时间为80分钟(范围50 - 120分钟±16.020)。4例(8%)因出血和胆囊三角区解剖困难而转为标准四孔腹腔镜胆囊切除术。术中出血量极少,无术后并发症。住院时间为1 - 2天(平均1.08±0.274)。

结论

使用传统腹腔镜器械进行单孔腹腔镜胆囊切除术是一种安全可行的手术方法,无需额外花费购买单孔和关节式器械。美容效果极佳,手术时间增加极少。

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