改良三孔法与常规三孔法腹腔镜胆囊切除术的对比研究

目的:比较改良三孔法与常规三孔法腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床疗效。方法:58例行改良三孔法LC,146例行常规三孔法LC;对比两组手术时间、术中出血量、中转率、术后疼痛、患者满意度、术后住院时间及并发症发生情况。结果:两组均无中转开腹及严重并发症发生。改良组1例中转为4孔法LC,常规组3例中转为4孔法LC,两组中转4孔率分别为1.7%与2.1%(P0.05);改良组与常规组手术时间分别为(45.9±10.6)min与(39.8±9.4)min(P0.05);术中出血量分别为(24.7±5.4)ml与(23.4±6.6)ml(P0.05);术后疼痛评分分别为(2.1±0.6)与(2.8±0.5)(P0.05);术后平均住院(2.4±0.6)d与(2.5±0.5)d(P0.05);术后满意度评分分别为(94.3±4.9)与(89.8±4.6)(P0.05)。结论:改良三孔法与常规三孔法LC一样安全、有效,但改良法术后疼痛更轻,患者满意度更高,可为患者带来更大受益。

Comparative study of modified three-port versus conventional three-port laparoscopic cholecystectomy

Objective:To compare the clinical efficacy of modified three-port and conventional three-port laparoscopic cholecys-tectomy ( LC) .Methods:Fifty-eight elective patients and one hundred and forty-six elective patients were performed modified three-port LC and conventional three-port LC,respectively.Operative time,blood loss,conversion rate,postoperative wound pain,patients’ satis-faction,hospital stay,and complications were compared between the two groups .Results:There was no conversion to laparotomy ,no seri-ous postoperative complications occurred in the two groups .One case and three cases were converted to four-port LC in modified and conventional LC groups,the conversion rate was 1.7%and 2.1%,respectively (P>0.05).The operative time in modified and conven-tional LC groups were (45.9 ±10.6) min and (39.8 ±9.4) min,respectively (P<0.05).The blood loss and hospital stay in the two groups were not statistically significantly different (P>0.05).Moreover,the scores for postoperative wound pain were (2.1 ±0.6) and (2.8 ±0.5) in modified and conventional LC groups ,the difference was statistically significant (P<0.05).The scores for patients’ satisfaction in modified and conventional LC groups were (94.3 ±4.9) and (89.8 ±4.6),respectively (P<0.05).Conclusions:Modified three-port and conventional three-port LC are safe and effective.However,the modified three-port LC shows lighter postopera-tive wound pain ,and higher satisfaction of patients ,which are more beneficial for patients .