Liu Fuguo, Cui Ran, Mutailipu Muladili, Zhao Zinan, Wang Xujing, Chen Bo, Wang Yongkun
Department of Hepatopancreatobiliary Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
J Laparoendosc Adv Surg Tech A. 2025 Jan;35(1):36-41. doi: 10.1089/lap.2024.0325. Epub 2024 Oct 23.
With the rising demand for minimally invasive and cosmetically appealing surgeries, transumbilical single-incision laparoscopic cholecystectomy (SILC) has been increasingly adopted, albeit in a limited number of medical centers. Our team has successfully executed transumbilical SILC for benign gallbladder diseases. This study retrospectively analyzed and compared the efficacy of transumbilical SILC with that of conventional laparoscopic cholecystectomy (CLC). We analyzed data from 358 cases of laparoscopic cholecystectomy performed at Shanghai East Hospital of Tongji University between January 2021 and October 2023. Of these, 186 cases underwent SILC (observation group), while 172 cases underwent CLC (control group). We compared patient demographics, perioperative outcomes, and satisfaction with incision scars. Primary outcomes included surgical efficacy and safety, whereas secondary outcomes encompassed postoperative hospitalization duration, pain levels, hospital costs, and scar satisfaction. No significant differences were observed in patient demographics between the two groups. Both the SILC and CLC groups exhibited similar operative times (39.56 ± 14.55 minutes versus 41.82 ± 16.13 minutes, = .164) and intraoperative blood loss (11.34 ± 3.90 mL versus 11.28 ± 3.87 mL, = .885). The single-incision approach led to earlier postoperative bowel function recovery (22.03 ± 3.60 hours versus 24.17 ± 3.22 hours, < .01), lower 24-hour postoperative pain scores (2.06 ± 0.84 versus 2.35 ± 0.72, < .01), shorter postoperative hospital stays (2.88 ± 0.86 days versus 3.33 ± 0.96 days, < .01), comparable hospitalization costs (3411.67 ± 790.86$ versus 3494.50 ± 558.76$, = .257), and better Scar Cosmesis Assessment and Rating scores (1.78 ± 0.70 versus 2.17 ± 0.89, < .01). Patient satisfaction was higher with the single-incision technique (8.52 ± 0.79 versus 7.80 ± 0.75, < .01). Both groups experienced one case of incision infection (SILC 0.54%, CLC 0.58%), and there was one case of postoperative bile leakage in the CLC group (0.58%). However, the difference in complications was not statistically significant ( > .05). Transumbilical SILC demonstrates safe and effective near-term efficacy, offering benefits such as reduced postoperative pain and improved cosmetic outcomes, which support its clinical adoption.
随着对微创和美观手术需求的不断增加，经脐单孔腹腔镜胆囊切除术（SILC）尽管仅在少数医疗中心开展，但已越来越多地被采用。我们团队已成功为良性胆囊疾病实施了经脐SILC。本研究回顾性分析并比较了经脐SILC与传统腹腔镜胆囊切除术（CLC）的疗效。我们分析了2021年1月至2023年10月在同济大学附属东方医院进行的358例腹腔镜胆囊切除术的数据。其中，186例接受了SILC（观察组），172例接受了CLC（对照组）。我们比较了患者的人口统计学特征、围手术期结果以及对切口瘢痕的满意度。主要结局包括手术疗效和安全性，次要结局包括术后住院时间、疼痛程度、住院费用和瘢痕满意度。两组患者的人口统计学特征无显著差异。SILC组和CLC组的手术时间相似（39.56±14.55分钟对41.82±16.13分钟，P = 0.164），术中出血量也相似（11.34±3.90毫升对11.28±3.87毫升，P = 0.885）。单孔手术使术后肠功能恢复更早（22.03±3.60小时对24.17±3.22小时，P < 0.01），术后24小时疼痛评分更低（2.06±0.84对2.35±0.72，P < 0.01），术后住院时间更短（2.88±0.86天对3.33±0.96天，P < 0.01），住院费用相当（3411.67±790.86美元对3494.50±558.76美元，P = 0.257），瘢痕美容评估和评分更高（1.78±0.70对2.17±0.89，P < 0.01）。单孔技术的患者满意度更高（8.52±0.79对7.80±0.75，P < 0.01）。两组均有1例切口感染（SILC 0.54%，CLC 0.58%），CLC组有1例术后胆漏（0.58%）。然而，并发症的差异无统计学意义（P > 0.05）。经脐SILC显示出安全有效的近期疗效，具有减轻术后疼痛和改善美容效果等优势，支持其在临床中的应用。
