经脐单孔腹腔镜与传统腹腔镜胆囊切除术的对比研究

目的：探讨现阶段经脐单孔腹腔镜胆囊切除术（laparoscop ic cholecystectomy,LC）的安全性、可行性及优势。方法：回顾分析山东大学齐鲁医院开展的经脐单孔LC（A组,n=12）及同期完成的传统LC（B组,n=23）的临床资料。对比两组手术时间、术中出血量、术后住院时间、并发症发生率及总住院费用等指标。结果：35例手术均获成功,术后无并发症发生。两组术中出血量差异无统计学意义（P〉0.05）,经脐单孔LC组术后住院时间及总住院费用明显优于传统LC组（P〈0.01）,而传统组手术时间则优于经脐单孔组（P〈0.01）。在经脐单孔组组内对比发现,手术时间随手术量的增加有逐渐减少的趋势,其中后4例手术时间明显少于前4例（P〈0.01）。结论：目前经脐单孔LC是安全可行的,术后住院时间及总住院费用明显优于传统LC,具有成为一定时期内主流LC的潜力。

Comparative study between transumbilical single port laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy

Objective:To discuss the safety,feasibility and advantages of transumbilical single port laparoscopic cholecystectomy.Methods:The clinical documents of the patients who had been admitted into the Qilu Hospital,and undergone transumbilical single port laparoscopic(group A,n=12) and conventional laparoscopic cholecystectomy(group B,n=23) in the period of Nov.2008 to Nov.2009 were reviewed.Their operation time,blood loss,hospital stay after operation,complications rate and the total cost were contrasted.Results:All operations were successful,no post-operative complications occurred in both groups,as to blood loss,group A and B had no significant difference(P>0.05).As to post-operative hospital stay and the total hospital cost,group A was much superior to group B(P<0.01).However,as to operation time,group B was superior to group A(P<0.01).The same time,comparison in group A,operation time had a decreasing trend,the operation time of the later 4 cases was significantly less than the former 4 cases(P<0.01).Conclusions:Transumbilical single port laparoscopic cholecystectomy is a safe and feasible operation.It has the advantages of mini-invasion,rapid recovery,short hospitalization and less total hospital cost than conventional laparoscopic cholecystectomy.It will demonstrate the superiority and become the mainstream laparoscopic cholecystectomy.