两孔法和三孔法腹腔镜胆囊切除术的对比研究

目的:比较两孔法与三孔法腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床疗效,探讨两孔法LC应用的可行性。方法:随机双盲选择2007年1月至2008年12月我院收治的239例患者,由同一位医师连续用两孔法或三孔法施行LC。比较两种术式的手术时间、术后疼痛、术后肛门排气时间、术后下床活动时间、术后住院天数、术后并发症及满意度。结果:所有患者均顺利完成LC,无一例中转开腹。两孔法组1例因粘连较重改行三孔法LC,术后疼痛较轻,满意度较高(P<0.05),其余各项指标差异均无统计学意义(P>0.05)。结论:相对于三孔法,两孔法LC同样安全、可靠,并且具有患者术后疼痛轻,腹部美容效果好及满意度高等优点。

Comparative study of two-port and three-port laparoscopic cholecystectomy

Objective:This study aims to compare the clinical effects of two-port and three-port laparoscopic cholecystectomy(LC) so as to investigate the feasibility of two-port LC.Methods:Two hundred and thirty-nine patients,chosen in a random and double-blind manner from Wuxi People's Hospital from Jan.2007 to Dec.2008,were operated with two-port and three-port LC,which were performed continuously by the same surgeon.Then operating time,postoperative pain,postoperative anal exhaust time,postoperative out-of-bed activity time,postoperative hospitalization time,postoperative complication and satisfaction were compared between two groups.Results:LC was successfully performed in all of the cases,without conversion to laparotomy.In two-port group,one case had to be shifted into three-port LC due to severe adhesion.In two-port group,postoperative pain was lighter,and postoperative satisfaction was higher(P<0.05).Other parameters showed no statistic significance(P>0.05).Conclusions:Compared with three-port LC,two-port LC is of the same safety and reliability,while the postoperative pain is less,abdominal cosmetic result is better and postoperative satisfaction is higher.