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单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术在日间病房中的可行性和安全性。

Feasibility and safety of single-incision laparoscopic cholecystectomy versus conventional laparoscopic cholecystectomy in an ambulatory setting.

机构信息

Department of Biliary- Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China.

Department of Biliary- Pancreatic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160, Pujian Road, Shanghai 200127, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2019 Jun;18(3):273-277. doi: 10.1016/j.hbpd.2019.04.008. Epub 2019 Apr 23.

Abstract

BACKGROUND

Single-incision laparoscopic surgery has emerged as an alternative to conventional laparoscopic cholecystectomy (LC) in the clinical setting. Limited information is available on the possibility of performing single-incision laparoscopic surgery as an ambulatory procedure. This study aimed to determine the feasibility and safety of single-incision laparoscopic cholecystectomy (SILC) versus conventional LC in an ambulatory setting.

METHODS

Ninety-one patients were randomized to SILC (n = 49) or LC (n = 42). The success rate, operative duration, blood loss, hospital stay, gallbladder perforation, drainage, delayed discharge, readmission, total cost, complications, pain score, vomiting, and cosmetic satisfaction of the two groups were then compared.

RESULTS

There were significant differences in the operative time (46.89 ± 10.03 min in SILC vs. 37.24 ± 10.23 min in LC; P < 0.001). As compared with LC, SILC was associated with lower total costs (8012.28 ± 752.67 RMB vs. 10258.91 ± 1087.63 RMB; P < 0.001) and better cosmetic satisfaction (4.94 ± 0.24 vs. 4.74 ± 0.54; P = 0.031). There were no significant differences between-group in terms of general data, success rate, blood loss, hospital stay, gallbladder perforation, drainage, delayed discharge, readmission, complications, pain score, and vomiting (P > 0.05).

CONCLUSIONS

Ambulatory SILC is safe and feasible for selected patients. The advantages of SILC as compared with LC are improved cosmetic satisfaction and lower total costs.

摘要

背景

单切口腹腔镜手术已成为传统腹腔镜胆囊切除术(LC)在临床环境中的替代方法。关于单切口腹腔镜胆囊切除术(SILC)作为日间手术的可能性,目前仅有有限的信息。本研究旨在确定日间环境中单切口腹腔镜胆囊切除术(SILC)与传统 LC 的可行性和安全性。

方法

91 名患者随机分为 SILC 组(n=49)或 LC 组(n=42)。比较两组的成功率、手术时间、出血量、住院时间、胆囊穿孔、引流、延迟出院、再入院、总费用、并发症、疼痛评分、呕吐和美容满意度。

结果

SILC 组的手术时间明显长于 LC 组(46.89±10.03 分钟 vs. 37.24±10.23 分钟;P<0.001)。与 LC 相比,SILC 总费用更低(8012.28±752.67 人民币 vs. 10258.91±1087.63 人民币;P<0.001),美容满意度更高(4.94±0.24 vs. 4.74±0.54;P=0.031)。两组在一般资料、成功率、出血量、住院时间、胆囊穿孔、引流、延迟出院、再入院、并发症、疼痛评分和呕吐方面无统计学差异(P>0.05)。

结论

对于选择的患者,日间 SILC 是安全可行的。与 LC 相比,SILC 的优势在于美容满意度提高和总费用降低。

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