三孔法与经典腹腔镜胆囊切除术的对比研究

目的比较“三孔法”与经典腹腔镜胆囊切除术（LC）的效果：方法采用“双肓随机对照”将400例慢性结石性胆囊炎择期于术患者分成2组，分别行三孔法LC与经典LC，比较2组手术时间、成功率、术后不同部位及整体疼痛程度、止痛剂使用情况、并发症、术后平均住院时间以及切口美容效果。结果2组在手术时间、成功率、并发症以及术后平均住院时间方面无明显差异；三孔LC组右肋缘下疼痛程度比经典LC组轻，而2组在剑下疼痛、擎体疼痛程度以及止痛剂使用情况无明显差别；三孔LC组切口美容效果好于经典LC组。结论和经典LC相比，三孔LC并没有因为戳孔的减少而增加手术的难度，同时具有良好的安全性，切口局部疼痛程度轻，美容效果更好，值得推广。

Three-port vs standard four-port laparoscopic cholecystectomy: a prospective randomized double-blind trial

Objective To report a randomized trial in comparing the clinical outcomes of three-port LC versus standard four-port LC. Methods From March 2001 to August 2004, four hundred consecutive patients who underwent elective LC were randomized to receive either the three-port or the four-port technique. All patients were blinded to the type of operation they underwent. Postoperative overall pain and incisional pain at different sites were assessed on the first day after surgery using the Prince-Henry scale. Other outcome measures included length and success of the operation, analgesia requirements, postoperative complications, postoperative stay, and the cosmetic results. Results There was no difference between the two groups in age, sex, weight or other diseases. In terms of outcome, patients in the three-port group had less pain at individual subcostal port sites and better cosmetic results. Success rate, mean operative time, complications, subxiphoid port and overall pain score, analgesia requirements, and postoperative hospital stay were similar between these two groups. Conclusion Three-port LC resulted in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port LC. The three-port technique is as safe as the standard four-port procedure for LC. Thus, it can be recommended as a routine procedure in elective LC.