两孔腹腔镜胆囊切除术的探讨

目的探讨两孔腹腔镜胆囊切除术(LC)的安全性、可行性及优势。方法回顾性分析2008年6月至2010年10月期间无锡市人民医院开展的两人两孔LC(两孔LC组,n=46)及同期完成的两人三孔LC(三孔LC组,n=68)胆囊结石患者的临床资料,比较2组的手术时间、术中出血量、术后进食时间、术后疼痛评分、术后住院时间及总住院费用。结果 114例患者手术均获成功,术中、术后无并发症发生。两孔LC组的手术时间明显长于三孔LC组(P<0.05);2组的术中出血量、术后进食时间、术后疼痛评分及术后住院时间比较差异均无统计学意义(P>0.05);两孔LC组的住院费用明显低于三孔LC组(P<0.05)。结论两人两孔LC在单纯胆囊结石病例安全、可行,总住院费用低于两人三孔LC;在胆囊结石合并急性胆囊炎病例,因视野及操作均受限,应谨慎开展。

Clinical Application of Two-Port Laparoscopic Cholecystectomy

Objective To discuss the safety,feasibility,and advantages of two-port laparoscopic cholecystectomy(LC).Methods The clinical data of 114 patients underwent LC from June 2008 to October 2010 were retrospectively analyzed,of which 46 underwent two-port LC(two-port LC group,n=46) and 68 underwent three-port LC(three-port LC group,n=68).The operation time,intraoperative blood loss,postoperative feeding time,postoperative pain,postoperative hospital stay,and hospitalization expenses were compared between two groups.ResultsAll the operations were successful,no postoperative complications occurred in both groups.The operation time in the two-port LC group was longer than that in the three-port LC group(P<0.05).The intraoperative blood loss,postoperative feeding time,postoperative pain,and postoperative hospital stay had no significant differences in two groups(P>0.05).The hospitalization expenses in the two-port group was less than that in the three-port group(P<0.05).ConclusionsTwo-port LC is a safe and feasible operation in the simple gallstone patients.It is cautious in those patients with acute cholecystitis because of the restricted vision and operation.