单孔腹腔镜（完全经脐）下胆囊切除术25例临床报告.docVIP

单孔腹腔镜（完全经脐）下胆囊切除术25例临床报告 　　【摘要】 目的：探讨单孔腹腔镜（完全经脐）胆囊切除术的疗效及应用价值。方法：回顾性分析笔者所在医院收治的25例完全经脐单孔腹腔镜切除术患者的临床资料。结果：19例手术成功，3例中转改为三孔腹腔镜，3例中转开腹胆囊切除术，手术时间为40～180 min，平均65.2 min。患者术后无出血、胆汁漏等并发症发生，恢复良好，患者对治疗及美容效果满意。结论：单孔腹腔镜切除术安全可行，但手术难度大于常规LC术，必须在熟练掌握传统LC的基础上进行，手术可使用专用的器械，注意适应证选择的把握，其微创和美容效果明显优于传统LC，可达到腹部无可见瘢痕的效果，具有临床推广价值。 　　【关键词】 单切口； 单孔； 脐； 胆囊切除术； 腹腔镜 　　中图分类号 R657.4 文献标识码 B 文章编号 1674-6805（2016）10-0093-02 　　【Abstract】 Objective：To investigate the therapeutic effect and application value of totally transumbilical single port laparoscopic cholecystectomy.Method：The clinical data of 25 cases with totally transumbilical single port laparoscopic cholecystectomy were retrospectively analyzed.Result：19 cases were operated successfully，3 cases were converted to three hole laparoscopy，3 cases were converted to open cholecystectomy，the operation time were 40-180 min，with an average of 65.2 min.No bleeding，bile leakage and other complications occurred，the recovery of good，patients were satisfactory with the treatment and cosmetic results.Conclusion：The transumbilical single port laparoscopic cholecystectomy is safe and feasible，but the difficulty of the operation is greater than that of conventional LC，must be in the master on the basis of the traditional LC，and the operation can use special instruments，attention to the choice of indications，the minimally invasive surgery and cosmetic effect is obviously superior to the traditional LC，no visible scar effect reach the abdomen，which is worthy of clinical promotion. 　　【Key words】 Single incision； Single port； Umbilicus； Cholecystectomy； Laparoscope 　　First-author’s address：The Fourth People’s Hospital of Changde，Changde 415000，China 　　doi：10.14033/j.cnki.cfmr.2016.10.049 　　腹部腹腔镜手术是一种利用前方带有微型摄像头的器械进行腹部手术的方式，腹腔镜胆囊切除术自20世纪80年代开始应用于临床。临床上多采用3～4孔法[1]，随着常规多孔腹腔镜技术的日臻完善，无创/微创的观念越来越受到人们的重视，经自然孔道内镜外科的理念正是在这种情况下产生的，已普遍为人们所接受。经脐单孔腹腔镜是利用人体天然瘢痕-肚脐，将传统腹腔镜手术的多个穿刺孔汇集到脐部单一孔道，通过脐孔放置常规或专用手术器械来进行手术操作，其微创和美容效果突出，笔者所在医院自2013年3月-2015年3月完成了25例经完全脐单孔腹腔镜胆囊切除