常规器械经脐单孔两通道腹腔镜胆囊切除术临床的应用.docVIP

常规器械经脐单孔两通道腹腔镜胆囊切除术临床的应用 　　[摘要] 目的 探讨常规器械经脐单孔两通道腹腔镜胆囊切除术的临床疗效及应用价值。方法 回顾性分析2010年9月―2017年3月该院普外科?_展的常规器械经脐单孔两通道腹腔镜胆囊切除术380例的临床资料。结果371例成功实现了常规器械经脐单孔两通道腹腔镜胆囊切除术，成功率达97.63%。6例改为两孔法，3例改为三孔法。平均手术时间51 min；术后疼痛评分平均2.5分，平均住院时间4.6 d ，无腹腔内出血、胆漏、黄疸、切口感染等并发症的发生，术后仅脐部隐蔽的微小疤痕，美容效果明显。术后随访3个月、6个月及1年，均无腹痛、黄疸、穿刺孔疝等。 结论 常规器械经脐单孔两通道腹腔镜胆囊切除术是即经济实惠，又安全可行的，具有更加美观、微创，疼痛轻，住院时间短，恢复快等优点，符合患者心理需求，适合在我国基层医院推广。 　　[关键词] 经脐单孔腹腔镜；胆囊切除术；常规器械 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2017）11（b）-0039-04 　　[Abstract] Objective This paper tries to discuss about the clinical efficacy and the value of application in transumbilical single-port double trocars laparoscopic cholecystectomy using conventional laparoscopical instruments. Methods The clinical data of 380 patients who underwent transumbilical single-port double trocars laparoscopical cholecystectomy from September 2001 to March 2017 were retrospectively analyzed. Conventional laparoscopical instruments were used in all the surgeries. Results Surgical procedures were performed successfully in 371 cases and the success rate was 97.63%. 6 cases were converted to double-port procedures， and 3 cases were converted to three-port procedures. The average time of surgery was 51 minutes， mean visual analgesic scores （VAS） was 2.5 points； average hospital stay was 4.6 days. No postoperative complications such as abdomen bleeding， bile leakage， jaundice or incisional infection occurred. Umbilical incision was small and microscopic. No abdomen pain， jaundice and incisional hernia occurred after three， six， and twelve months of follow-up. Conclusion Transumbilical single-port double trocars laparosopic cholecystectomy using conventional laparoscopical instruments is an economical， safe and reliable approach， and it has many advantages such as： better cosmetic results， fewer invasive procedures， lesser pain， shorter hospitalization and earlier return to daily activities， which can meet the patient’s psychological needs， therefore it is worthy of applicat