| 摘要: |
| 目的 比较两孔法和单孔法腹腔镜保胆取石术的优缺点，探讨其临床应用的可行性、优越性及手术技巧。方法 将2015年3月至2016年10月就诊的32例胆囊结石患者随机分为两孔法腹腔镜保胆取石术(两孔组)或单孔法腹腔镜保胆取石术(单孔组)，每组16例，比较两组的手术时间、手术出血量、术后疼痛、术后肠蠕动恢复时间、术后并发症、住院时间及患者满意度。结果 两孔组16例均顺利完成手术，取净结石；单孔组3例患者因腹腔黏连改为两孔法腹腔镜保胆取石术。两孔组手术时间和术中出血量明显小于单孔组（P＜0.05)。两组术后疼痛、肛门排气时间、住院时间、满意度差异无统计学意义（P>0.05），术后均无并发症发生；随访6~24个月均无结石复发。结论 两孔法腹腔镜保胆取石术安全可行，具有手术操作难度低、时间短、术中出血少等优点。 |
| 关键词: 胆石病 保胆取石术 腹腔镜 胆道镜 随机对照研究 |
| DOI：10.16118/j.1008-0392.2018.01.003 |
| 投稿时间：2017-10-19 |
| 基金项目:上海市浦东新区卫生系统重点专科建设资助项目（PWZzk2017-10） |
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| Laparoscopic gallbladder-preserving cholecystolithotomy: dual-port versus single-port |
| HE Chuan-qi,HU Hai |
| (Center of Gallstone Disease, East Hospital, Tongji University, Shanghai 200120, China) |
| Abstract: |
| Objective To evaluate the advantages and disadvantages of dual-port laparoscopic gallbladder-preserving cholecystolithotomy (DPLC) with single-port laparoscopic gallbladder-preserving cholecystolithotomy (SPLC). Methods Thirty-two patients scheduled to undergo gallbladder-preserving cholecystolithotomy from March 2015 to October 2016 were divided randomly into DPLC group and SPLC group with 16 patients in each group. The operation time, intraoperative blood loss, bowl movement recovery time, postoperative pain, postoperative complication, length of hospital stay and the patient satisfaction score (PSS) were compared between two groups. Results Operations were successful in all patients of DPLC group with complete stone clearance; while 3 cases in SPLC group were converted to DPLC because of adhesion in the abdominal cavity. The operation time and intraoperative blood loss in DPLC group were significantly less than those in SPLC group (P＜0.05). There were no significant differences in postoperative pain (VAS), bowl movement recovery time, length of hospital stay and PSS between two groups. No postoperative complications occurred in both groups. All patients were followed up for 6-24 months, there was no stone recurrence. Conclusion Dual-port laparoscopic chlecystolithotomy is a safe, effective and feasible procedure with less operation time and blood loss. |
| Key words: cholecystolithiasis gallbladder-preserving cholelithotomy laparoscopy choledochoscopy randomized controlled trial |
