经脐单孔腹腔镜胆囊切除术

目的:探讨采用标准多孔腹腔镜胆囊切除术分离与显露技术施行经脐单孔腹腔镜胆囊切除术(transumbilical single-incision laparoscopic cholecystectomy,SILC)的安全性、可行性及应用价值.方法:回顾分析为20例慢性结石性胆囊炎患者施行SILC的临床资料.通过脐部1.8...

Transumbilical single-incision laparoscopic cholecystectomy

Objective: To evaluate the safety,feasibility and clinical application value of the laparoscopic cholecystectomy which was performed through a single incision within the umbilicus while maintaining standard separation and exposure techniques of currently performed multiport laparoscopic cholecystectomy. Methods:The clinical data of 20 patients with chronic calculous cholecystitis who underwent transumbilical single-incision laparoscopic cholecystectomy were retrospectively analyzed.The entire procedure was performed through a single incision measuring 1.8-2.0 cm within the umbilicus.Three Trocars and a rigid grasper were inserted through separate fascial sites within the same skin incision.The cholecystectomy procedures were then performed in the standard fashion described in multi-port laparoscopic cholecystectomy. Results:Transumbilical single-incision laparoscopic cholecystectomy were successfully accomplished in all the 20 patients.The operation time was 90-200 min,and the mean was 130 min.The patients resumed liquid diet 24 h later,and were discharged from hospital in three to five days after operation.All patients recovered rapidly without any complications such as postoperative hemorrhage,iatrogenic bile duct injury,biliary fistula,infection of incisional wound and so on.Postoperative reexamination of the incision showed that the incisional scar was concealed and not easily observed,and all patients were satisfied with the cosmetic results. Conclusions:The initial experience with transumbilical single-incision laparoscopic cholecystectomy demonstrates its safety and feasibility,and the technique is easily taught and performed without the restrictions of new equipment or increase of cost,and has better cosmetic effect.