Clinical efficacy of transumbilical single-port laparoscopic cholecystectomy in treatment of cholecystolithiasis

doi:10.3877/cma.j.issn.2095-3232.2024.03.013

Abstract

Abstract:

Objective

To evaluate the safety and efficacy of transumbilical single-port laparoscopic cholecystectomy (LC) in the treatment of cholecystolithiasis.

Methods

Clinical data of 201 patients with cholecystolithiasis who underwent LC in Hainan Cancer Hospital from June 2018 to June 2022 were retrospectively analyzed. Among them, 91 patients were male and 110 female, aged from 27 to 74 years, with a median age of 51 years. The informed consents of all patients were obtained and the local ethical committee approval was received. According to surgical methods, all patients were divided into single-port LC group (single-port group, n=107) and three-port LC group (three-port group, n=94). Operation time and satisfaction score between two groups were compared by t test. The incidence of complications and the conversion rate to open surgery were compared by using Chi-square test or Fisher's exact test.

Results

All patients intwo groups successfully completed the surgery. 1 patient in the single-port group was converted to open surgery, and none in the three-port group, with no statistical significance between two groups (P=0.347). No statistical significance was found in intraoperative blood loss, operation time, length of hospital stay and hospitalization expenses between two groups (P>0.05). Subgroup analysis showed that for patients with cholecystolithiasis of >2 cm, the average operation time in the single-port group was (44±8) min, significantly shorter than (55±7) min in the three-port group (t=-12.685, P<0.05). The incidence of postoperative complications in the single-port group was 1.9%(2/107), and 2.1%(2/94) in the three-port group, with no statistical significance (χ²=0.418, P>0.05). In single-port group, the satisfaction score of patients was 42.8±2.8, significantly higher than 33.7±4.9 in the three-port group (t=32.710, P<0.05).

Conclusions

Transumbilical single-port LC is safe and efficacious treatment of cholecystolithiasis, which has the advantages of better cosmetic effect and higher satisfaction score. For patients with cholecystolithiasis of >2 cm, the operation time of single-port LC is shorter.

Key words: Cholecystolithiasis, Cholecystectomy, Single-port, Three-port, Cosmetic, Operation time

Rui Zou, Yiyao Wang, Zepeng Huang, Duo Li. Clinical efficacy of transumbilical single-port laparoscopic cholecystectomy in treatment of cholecystolithiasis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(03): 334-338.

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References 21

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组别	例数（例）	年龄（岁，±s）	性别（例）		WBC （×10⁹/L，±s）	AST （U/L，±s）	ALT （U/L，±s）	GGT （U/L，±s）	胆总管内径（mm，±s）	BMI （kg/m²，±s）	胆囊壁厚度[cm，M（Q₁，Q₃）]
组别	例数（例）	年龄（岁，±s）	男	女	WBC （×10⁹/L，±s）	AST （U/L，±s）	ALT （U/L，±s）	GGT （U/L，±s）	胆总管内径（mm，±s）	BMI （kg/m²，±s）	胆囊壁厚度[cm，M（Q₁，Q₃）]
单孔组	107	45±14	49	58	5.7±2.5	17±4	32±5	11±6	16±6	21.2±2.4	0.3（0.3，0.4）
三孔组	94	42±16	42	52	6.0±2.1	18±5	29±7	14±5	17±5	20.9±3.1	0.3（0.3，0.4）
统计值		t=2.730	χ²=1.620		t=-0.350	t=-2.130	t=0.280	t=-0.470	t=-1.560	t=0.150	Z=-0.280
P值		0.130	0.870		0.930	0.180	0.410	0.140	0.120	0.240	0.170

组别	例数（例）	年龄（岁，±s）	性别（例）		WBC （×10⁹/L，±s）	AST （U/L，±s）	ALT （U/L，±s）	GGT （U/L，±s）	胆总管内径（mm，±s）	BMI （kg/m²，±s）	胆囊壁厚度[cm，M（Q₁，Q₃）]
组别	例数（例）	年龄（岁，±s）	男	女	WBC （×10⁹/L，±s）	AST （U/L，±s）	ALT （U/L，±s）	GGT （U/L，±s）	胆总管内径（mm，±s）	BMI （kg/m²，±s）	胆囊壁厚度[cm，M（Q₁，Q₃）]
单孔组	107	45±14	49	58	5.7±2.5	17±4	32±5	11±6	16±6	21.2±2.4	0.3（0.3，0.4）
三孔组	94	42±16	42	52	6.0±2.1	18±5	29±7	14±5	17±5	20.9±3.1	0.3（0.3，0.4）
统计值		t=2.730	χ²=1.620		t=-0.350	t=-2.130	t=0.280	t=-0.470	t=-1.560	t=0.150	Z=-0.280
P值		0.130	0.870		0.930	0.180	0.410	0.140	0.120	0.240	0.170

组别	例数	术中出血量（ml）	手术时间（min）	住院时间（d）	住院费用（万元）	满意度评分（分）
单孔组	107	6±3	51±11	2.1±0.8	1.35±0.08	42.8±2.8
三孔组	94	7±3	51±9	2.1±0.8	1.36±0.08	33.7±4.9
t值		-1.026	0.024	0.022	-0.306	32.710
P值		0.312	0.981	0.881	0.581	0.016

组别	例数	术中出血量（ml）	手术时间（min）	住院时间（d）	住院费用（万元）	满意度评分（分）
单孔组	107	6±3	51±11	2.1±0.8	1.35±0.08	42.8±2.8
三孔组	94	7±3	51±9	2.1±0.8	1.36±0.08	33.7±4.9
t值		-1.026	0.024	0.022	-0.306	32.710
P值		0.312	0.981	0.881	0.581	0.016

组别	例数	切口感染（例）	皮下气肿（例）	切口疝（例）	术后使用镇痛药（例）
单孔组	107	1	0	1	3
三孔组	94	1	1	0	4
统计值		χ²=0.008	-	-	χ²=0.314
P值		0.927	0.285	0.347	0.575

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