Hajong Ranendra, Dhal Malaya Ranjan, Natung Tanie, Khongwar Donkupar, Jyoti Arup Baruah, Newme Kewithinwangbo
Department of General Surgery, NEIGRIHMS, Shillong, Meghalaya, India.
J Family Med Prim Care. 2019 May;8(5):1617-1620. doi: 10.4103/jfmpc.jfmpc_172_19.
Gall bladder (GB) retrieval is an important cause for postoperative pain after laparoscopic cholecystectomy (LC). GB is usually extracted either from the epigastric or the umbilical port and there are limited data to decide the superiority of one over other in terms of postoperative pain. This study was designed to determine whether GB retrieval from the umbilical port was associated with less pain as compared to epigastric port in adult patients undergoing four ports elective LC.
A total of 100 patients took part in the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score was assessed at 1, 6, 12, and 24 h by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and the collected data were analyzed by using SPSS version 22.
VAS score for postoperative pain at epigastric port at 1, 6, 12, and 24 h found to be higher as compared to umbilical port (6.640 ± 1.494 vs. 5.500 ± 1.176, 6.620 ± 1.549 vs. 5.320 ± 1.188, 6.100 ± 1.549 vs. 4.660 ± 1.232, 5.250 ± 1.459 vs. 3.970 ± 1.274, respectively) which was statistically significant ( value 0.001). But the time taken for retrieval of GB was significantly longer in the umbilical group (4.94 ± 1.56 vs. 3.24 ± 1.29).
Umbilical port is better as compared to epigastric port for GB retrieval in patient undergoing elective four port LC in terms of postoperative port-site pain but it takes relatively longer time for the extraction.
胆囊取出是腹腔镜胆囊切除术(LC)后引起术后疼痛的一个重要原因。胆囊通常从剑突下或脐部端口取出,关于术后疼痛方面,判定哪一种方式优于另一种方式的数据有限。本研究旨在确定在接受四孔择期LC的成年患者中,与剑突下端口相比,从脐部端口取出胆囊是否疼痛较轻。
共有100例患者参与本研究,并随机分为2组。术后,通过视觉模拟量表(VAS)评分在1、6、12和24小时对所有患者的剑突下和脐部端口的术口疼痛评分进行评估,收集的数据使用SPSS 22版进行分析。
剑突下端口术后1、6、12和24小时的疼痛VAS评分高于脐部端口(分别为6.640±1.494 vs. 5.500±1.176、6.620±1.549 vs. 5.320±1.188、6.100±1.549 vs. 4.660±1.232、5.250±1.459 vs. 3.970±1.274),差异具有统计学意义(P值0.001)。但脐部组取出胆囊所需时间明显更长(4.94±1.56 vs. 3.24±1.29)。
对于接受择期四孔LC的患者,就术后术口疼痛而言,脐部端口在取出胆囊方面优于剑突下端口,但取出过程所需时间相对较长。