Comparative Study Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 陳英 , 林琳 , 付慶輝 , 姜曉峰 ,  梁健

中國醫科大學附屬第四醫院肝膽胰外科（遼寧沈陽 110032）;

Corresponding?author：

梁健, Email: liangj63110@vip.sina.com

Keywords：

單孔腹腔鏡; 膽囊切除術

DOI：

10.7507/1007-9424.20140050

Video：

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目的比較單孔腹腔鏡與傳統腹腔鏡膽囊切除術的臨床效果。方法選取2012年9月至2013年5月期間于我院就診的膽囊良性疾病患者，分別接受單孔腹腔鏡膽囊切除術（單孔腹腔鏡組，45例）和傳統腹腔鏡膽囊切除術（傳統腹腔鏡組，48例），分別觀察并對比2組患者的手術時間、術中出血量、術后（6 h和24 h）疼痛評分、止疼藥物的應用率、術后住院時間及患者對切口的滿意度。結果 2組患者術前的一般特征差異無統計學意義（P＞0.05）。單孔腹腔鏡組的手術時間明顯長于傳統腹腔鏡組〔（59.11±14.15）min比（40.21±11.11）min，P=0.00〕，術后6 h疼痛評分及止痛藥物應用率均明顯低于傳統腹腔鏡組〔6 h疼痛評分：（3.33±1.41）分比（4.60±1.30）分，P=0.00；止痛藥物應用率：6.67%（3/45）比31.25%（15/48），P=0.04〕，術后患者對切口的滿意度評分明顯高于傳統腹腔鏡組〔（4.76±6.00）分比（2.60±0.76）分，P=0.02〕。單孔腹腔鏡組和傳統腹腔鏡組的術中出血量、術后24 h疼痛評分及術后住院時間比較差異均無統計學意義〔術中出血量：（14.67±4.80）mL比（13.85±3.85）mL，P=0.36；24 h疼痛評分：（1.60±0.65）分比（1.80±0.70）分，P=0.14；術后住院時間：（3.11±0.77）d比（3.06±0.67）d，P=0.75〕。2組均無并發癥發生。結論單孔腹腔鏡較傳統腹腔鏡膽囊切除術可減輕術后疼痛，美容效果好，且并不增加手術風險。

Citation： 陳英, 林琳, 付慶輝, 姜曉峰, 梁健. Comparative Study Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(2): 217-219. doi: 10.7507/1007-9424.20140050 Copy

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10.	Markar SR, Karthikesalingam A, Thrumurthy S, et al.Single-incision laparoscopic surgery (SILS) vs.conventional multiport cholecystectomy:systematic review and meta-analysis[J].Surg Endosc, 2012, 26(5):1205-1213.
11.	Keus F, Gooszen HG, van Laarhoven CJ.Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis.An overview of Cochrane Hepato-Biliary Group reviews[J].Cochrane Database Syst Rev, 2010, (1):CD008318.
12.	Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, et al.Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy:a randomized controlled trial[J].Surg Endosc, 2010, 24(8):1842-1848.
13.	Bucher P, Pugin F, Buchs NC, et al.Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy[J].Br J Surg, 2011, 98(12):1695-1702.
14.	Kurpiewski W, Pesta W, Kowalczyk M, et al.The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy[J].Wideochir Inne Tech Malo Inwazyjne, 2012, 7(4):286-293.
15.	Abe N, Takeuchi H, Ueki H, et al.Single-port endoscopic cholecystectomy:a bridge between laparoscopic and translumenal endoscopic surgery[J].J Hepatobiliary Pancreat Surg, 2009, 16(5):633-638.
16.	Antoniou SA, Pointner R, Granderath FA.Single-incision laparo-scopic cholecystectomy:a systematic review[J].Surg Endosc, 2011, 25(2):367-377.
17.	Lai EC, Yang GP, Tang CN, et al.Prospective randomized com-parative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy[J].Am J Surg, 2011, 202(3):254-258.
18.	Hodgett SE, Hernandez JM, Morton CA, et al.Laparoendos-copic single site (LESS) cholecystectomy[J].J Gastrointest Surg, 2009, 13(2):188-192.

1. Litynski GS.Erich Mühe and the rejection of laparoscopic chole-cystectomy (1985):a surgeon ahead of his time[J].JSLS, 1998, 2(4):341-346.
2. Tacchino R, Greco F, Matera D.Single-incision laparoscopic cholecystectomy:surgery without a visible scar[J].Surg Endosc, 2009, 23(4):896-899.
3. Ma J, Cassera MA, Spaun GO, et al.Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy[J].Ann Surg, 2011, 254(1):22-27.
4. Navarra G, Pozza E, Occhionorelli S, et al.One-wound laparoscopic cholecystectomy[J].Br J Surg, 1997, 84(5):695.
5. 張忠濤, 韓威, 李建設, 等.經臍單孔腹腔鏡膽囊切除術1例報告[J].腹腔鏡外科雜志, 2008, 13(4):314.
6. Philipp SR, Miedema BW, Thaler K.Single-incision laparoscopic cholecystectomy using conventional instruments:early experience in comparison with the gold standard[J].J Am Coll Surg, 2009, 209(5):632-637.
7. Lee NY, Kim WY, Choi EH.Analysis of factors which reduce operation time in performance of single incision laparoscopic chol-ecystectomy[J].J Minim Invasive Surg, 2012, 15(3):63-67.
8. 周新華, 李宏, 陸才德, 等.腹腔鏡膽囊切除術中預防膽管損傷的經驗(附2694例報告)[J].中國普外基礎與臨床雜志, 2003, 10(5):499-500.
9. Erbella J Jr, Bunch GM.Single-incision laparoscopic cholecystectomy:the first 100 outpatients[J].Surg Endosc, 2010, 24(8):1958-1961.
10. Markar SR, Karthikesalingam A, Thrumurthy S, et al.Single-incision laparoscopic surgery (SILS) vs.conventional multiport cholecystectomy:systematic review and meta-analysis[J].Surg Endosc, 2012, 26(5):1205-1213.
11. Keus F, Gooszen HG, van Laarhoven CJ.Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis.An overview of Cochrane Hepato-Biliary Group reviews[J].Cochrane Database Syst Rev, 2010, (1):CD008318.
12. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, et al.Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy:a randomized controlled trial[J].Surg Endosc, 2010, 24(8):1842-1848.
13. Bucher P, Pugin F, Buchs NC, et al.Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy[J].Br J Surg, 2011, 98(12):1695-1702.
14. Kurpiewski W, Pesta W, Kowalczyk M, et al.The outcomes of SILS cholecystectomy in comparison with classic four-trocar laparoscopic cholecystectomy[J].Wideochir Inne Tech Malo Inwazyjne, 2012, 7(4):286-293.
15. Abe N, Takeuchi H, Ueki H, et al.Single-port endoscopic cholecystectomy:a bridge between laparoscopic and translumenal endoscopic surgery[J].J Hepatobiliary Pancreat Surg, 2009, 16(5):633-638.
16. Antoniou SA, Pointner R, Granderath FA.Single-incision laparo-scopic cholecystectomy:a systematic review[J].Surg Endosc, 2011, 25(2):367-377.
17. Lai EC, Yang GP, Tang CN, et al.Prospective randomized com-parative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy[J].Am J Surg, 2011, 202(3):254-258.
18. Hodgett SE, Hernandez JM, Morton CA, et al.Laparoendos-copic single site (LESS) cholecystectomy[J].J Gastrointest Surg, 2009, 13(2):188-192.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparative Study Between Single-Incision Laparoscopic Cholecystectomy and Conventional Laparoscopic Cholecystectomy

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