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本文引用的文献

1
Advantages and Disadvantages of 1-Incision, 2-Incision, 3-Incision, and 4-Incision Laparoscopic Cholecystectomy: A Workflow Comparison Study.单切口、双切口、三切口及四切口腹腔镜胆囊切除术的优缺点:一项工作流程比较研究
Surg Laparosc Endosc Percutan Tech. 2016 Aug;26(4):313-8. doi: 10.1097/SLE.0000000000000283.
2
Single-incision laparoscopic surgery for biliary tract disease.单孔腹腔镜手术治疗胆道疾病。
World J Gastroenterol. 2016 Jan 14;22(2):736-47. doi: 10.3748/wjg.v22.i2.736.
3
Transumbilical single-incision laparoscopic cholecystectomy: long-term review from a single center.经脐单孔腹腔镜胆囊切除术:来自单一中心的长期回顾
Surg Endosc. 2016 Aug;30(8):3375-85. doi: 10.1007/s00464-015-4618-7. Epub 2015 Nov 3.
4
Single incision versus standard multiport laparoscopic cholecystectomy: up-dated systematic review and meta-analysis of randomized trials.单切口与标准多端口腹腔镜胆囊切除术:随机试验的最新系统评价和荟萃分析
Surgeon. 2014 Oct;12(5):271-89. doi: 10.1016/j.surge.2014.01.009. Epub 2014 Feb 12.
5
A randomized clinical trial comparing 4-port, 3-port, and single-incision laparoscopic cholecystectomy.一项比较四孔、三孔和单切口腹腔镜胆囊切除术的随机临床试验。
J Invest Surg. 2014 Jun;27(3):147-54. doi: 10.3109/08941939.2013.856497. Epub 2013 Nov 11.
6
Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy.单孔腹腔镜胆囊切除术在美容评分方面具有优势,但疝的发生率显著升高:传统多孔腹腔镜胆囊切除术与单孔腹腔镜胆囊切除术前瞻性随机、多中心、单盲临床试验的 1 年结果。
J Am Coll Surg. 2013 Jun;216(6):1037-47; discussion 1047-8. doi: 10.1016/j.jamcollsurg.2013.02.024. Epub 2013 Apr 23.
7
Wound complications in 1145 consecutive transumbilical single-incision laparoscopic procedures.1145 例连续经脐单切口腹腔镜手术的伤口并发症。
Ann Surg. 2014 Jan;259(1):89-95. doi: 10.1097/SLA.0b013e31827b7818.
8
Single-incision vs three-port laparoscopic cholecystectomy: prospective randomized study.单切口与三孔腹腔镜胆囊切除术:前瞻性随机研究。
World J Gastroenterol. 2013 Jan 21;19(3):394-8. doi: 10.3748/wjg.v19.i3.394.
9
A prospective, randomized comparison of pain, inflammatory response, and short-term outcomes between single port and laparoscopic cholecystectomy.一项单孔腹腔镜与传统腹腔镜胆囊切除术的前瞻性随机对照研究:疼痛、炎症反应和短期结局比较。
Surg Endosc. 2013 Apr;27(4):1254-9. doi: 10.1007/s00464-012-2589-5. Epub 2012 Dec 12.
10
Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic cholecystectomy.随机对照临床试验:单孔、迷你腹腔镜与传统腹腔镜胆囊切除术的比较。
Br J Surg. 2013 Feb;100(3):339-49. doi: 10.1002/bjs.9003. Epub 2012 Nov 27.

单孔腹腔镜胆囊切除术术后并发症分析:来自一位外科医生的817例回顾性分析。

Analysis of post-operative complication in single-port laparoscopic cholecystectomy: A retrospective analysis in 817 cases from a surgeon.

作者信息

Lee Yongmin, Roh Younghoon, Kim Minchan, Kim Younghoon, Kim Kwanwoo, Kang Sunghwa, Jang Eunjeong

机构信息

Department of Medicine, Graduate School of Medicine Dong-A University, 32 Daesingongwon-Ro, Seo-Gu, Republic of Korea.

Department of Surgery, Dong-A University College of Medicine, Busan 49201, Republic of Korea.

出版信息

J Minim Access Surg. 2018 Oct-Dec;14(4):311-315. doi: 10.4103/jmas.JMAS_168_17.

DOI:10.4103/jmas.JMAS_168_17
PMID:29319016
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6130182/
Abstract

BACKGROUND

Single-port laparoscopic cholecystectomy (SPLC) is a new advanced technique in laparoscopic surgery which has many benefits according to previous reports. The purpose of this study was to present personal experiences with SPLC in >800 cases performed by a surgeon to evaluate the safety and feasibility of this procedure.

MATERIALS AND METHODS

A retrospective review of 817 cases of SPLC was conducted. All patients had received elective SPLC by a surgeon in our centre during March 2009-August 2015. Our review suggests patients' character, peri-operative data and post-operative outcome.

RESULTS

Three hundred and ninety-eight men (48.7%) and 419 women (51.3%) with an average age of 48.3 years had received SPLC. Their mean body mass index (BMI) was 23.75 kg/m. The mean operating time took 46.9 min (19-130). Seventy-nine cases (9.7%) needed additional port during operation. BMI, age and previous abdominal surgical history did not affect conversion to multiport surgery. Bile spillage during operation occurred in 73 cases (8.9%). There were 4 cases of open conversion because of bleeding (2 cases, 0.2%) and common bile duct (CBD) injury (2 cases, 0.2%). Mean duration of hospital stay was 2.36 days. We have experienced 38 cases (4.7%) of post-operative complication: 8 cases (1.0%) of major one and 30 cases (3.7%) of minor one. Major complication occurred in 3 cases (0.4%) of retained CBD stone, 3 cases (0.4%) of cystic duct leakage needed endoscopic retrograde cholangiopancreatography and 2 cases (0.2%) of CBD injury needed reoperation. Most minor complications were wound infections that have healed after conservative treatment. There were no post-operative mortalities.

CONCLUSION

SPLC is a safe and practicable technique. With surgical experience, criteria and area of SPLC can be broadened. SPLC is occupying a greater domain of a laparoscopic cholecystectomy.

摘要

背景

单孔腹腔镜胆囊切除术(SPLC)是腹腔镜手术中的一项新的先进技术,根据以往报道有诸多益处。本研究的目的是介绍一位外科医生实施800余例SPLC的个人经验,以评估该手术的安全性和可行性。

材料与方法

对817例SPLC病例进行回顾性分析。所有患者于2009年3月至2015年8月在本中心由同一位外科医生接受择期SPLC手术。我们的分析涵盖患者特征、围手术期数据及术后结果。

结果

817例接受SPLC的患者中,男性398例(48.7%),女性419例(51.3%),平均年龄48.3岁。他们的平均体重指数(BMI)为23.75kg/m²。平均手术时间为46.9分钟(19 - 130分钟)。79例(9.7%)患者术中需要增加辅助切口。BMI、年龄及既往腹部手术史并不影响转为多孔手术。术中胆汁外漏73例(8.9%)。因出血(2例,0.2%)和胆总管(CBD)损伤(2例,0.2%)中转开腹4例。平均住院时间为2.36天。我们共经历38例(4.7%)术后并发症:严重并发症8例(1.0%),轻微并发症30例(3.7%)。严重并发症包括3例(0.4%)胆总管残留结石、3例(0.4%)胆囊管漏需要内镜逆行胰胆管造影以及2例(0.2%)胆总管损伤需要再次手术。大多数轻微并发症为伤口感染,经保守治疗后愈合。无术后死亡病例。

结论

SPLC是一项安全可行的技术。随着手术经验的积累,SPLC的标准和适用范围可以拓宽。SPLC在腹腔镜胆囊切除术中所占的领域正日益扩大。