经脐单孔腹腔镜胆囊切除术在基层医院应用体会.docVIP

经脐单孔腹腔镜胆囊切除术在基层医院应用体会【摘要】目的:总结在基层医院开展经脐单孔腹腔镜胆囊切除术的临床经验。 方法:回顾分析成飞医院普通外科2010年5月～2011年3月运用原有普通腹腔镜器械进行的40例行经脐单孔腹腔镜胆囊切除术患者的临床资料。结果:本组患者中运用该方式完成38例胆囊切除，2例转为传统三孔腹腔镜手术。手术时间47～85min（平均68±10.46min），手术出血量5～30ml（平均14.9±5.10ml）,平均住院6 d。患者术后切口愈合良好,瘢痕隐蔽。随访1～10个月，无漏胆、胆管损伤、切口疝等并发症。结论:通过简单的改进，使用原有的普通腹腔镜器械就能够达到单孔腹腔镜的手术效果，并且安全易行，适合基层医院推广。 【关键词】普通器械；单孔腹腔镜手术；胆囊结石；基层医院 【中图分类号】R575.6+1【文献标识码】A【文章编号】1008-6455（2011）04-0353-02 The using experience of transumbilical laparoendoscopic single site cholecystectomy in basic-level hospitals Ruan Qi1 Hu Xiaodong1 Cui Lijuan2 et al. 【Abstract】Objective:To generalize the using experience of transumbilical laparoendoscopic single site cholecystectomy in basic-level hospitals.Methods:Review the clinical data of general surgery department of Cheng Fei Hospital from May 2010 to March 2011 by using the method to 40 cases of laparoscopic cholecystectomy. Results:Using this method in this group , we completed 38 cases of transumbilical laparoendoscopic single site cholecystectomy,2 cases into traditional three holes laparoscopic surgery.Theoperating time was 47～85min（mean 68±10.46min）. Theblood loss was 5～30ml（mean 14.9±5.10ml）. The mean hospital stay was 6 days . All the incisions were healed well and the surgical scar was satisfied and virtually concealed within the umbilicus. No postoperative complications were observed at follow-up 1～8 months. Conclusion:Through simple improvement, using the common devices laparoscopicdevices can be achieved the effect of single incision laparoscopic surgery. It is safe and easy , suitable for basic-level hospitals promotion. 【Key words】Common devices； single incision surgery； gallbladder stone;basic-level hospitals 2007年5月podolsky[1]等首先报道经脐单孔腹腔镜胆囊切除术后，国内多家医院开始采用该技术进行胆囊切除。我院从2010年5月起在遂宁市中心医院[2，3]的帮助下在成都地区的二级医院中率先开展此手术，取得良好相同效果，现报道如下。 1 资料和方法 1.1 一般资料:本组40例患者，男性18例，女性22例，年龄25～80岁，平均年龄为46.3±0.26岁，慢性胆囊炎伴胆囊结石27例，胆囊息肉13例。 1.2 纳入标准:符合胆囊良性病变，需要进行胆囊摘除病人。近期无胆囊急性炎症发作，无胆囊颈结石嵌顿。无严重心肺疾患能耐受全麻手术，高血压、糖尿病患者