Comparative study on the efficacy of transumbilical single port and three port laparoscopic cholecystectomy in the treatment of calculous cholecystitis / 国际外科学杂志

ABSTRACT

Objective:To explore the efficacy of transumbilical single-port and three-port laparoscopic cholecystectomy (LC) in the treatment of calculous cholecystitis and its influence on immunological indicators and recovery of gastrointestinal function.Methods:One hundred and twenty patients with calculous cholecystitis who were treated in Suzhou Municipal Hospital of Anhui Province from June 2018 to June 2020 were prospectively selected as the research subjects, and the patients were randomly divided into single-hole group and three-hole group by random number table method. Group of 60 cases. The single port group used the transumbilical single port method LC, and the three port group used the transumbilical three port method LC. Compare the 24-hour pain VAS scores and the use of analgesics of the two groups of patients; compare the surgical indicators of the two groups of patients; compare the immunological indicators of the two groups before and after treatment; compare the two groups of patients The recovery of gastrointestinal function after operation; the occurrence of postoperative complications between the two groups was compared.Results:There was no statistically significant difference in intraoperative blood loss, hospitalization expenses, preoperative IgG, IgA, IgM levels, and postoperative complications between the two groups of patients ( P>0.05). The two groups of patients had significantly lower levels of IgG, IgA, and IgM after treatment ( P<0.05). In the single hole group, the pain VAS score, the use rate of analgesics, the time of hospitalization, the time of anal exhaust, the time of bowel sound returning to normal and the time of defecation were (4.65±0.61) points, 11.67%(7/60), (2.52±0.47) d, (13.65±3.72) h, (11.64±3.25) h and (20.31±4.12) h, respectively. The three-hole group were (6.87±0.58) points, 23.33% (14/60), (4.58±0.37) d, (17.36±4.12) h, (15.47±4.12) h and (26.48±4.25) h, respectively. It was significantly lower in the single-hole group than in the three-hole group ( P<0.05). In the single hole group, the operation time, abdominal wall cosmetology score and the levels of IgG, IgA, IgM after treatment were (76.36±4.58) min, (4.72±0.13) points, (1 108.48±42.65) mg/dL, (208.12±10.86) mg/dL, (154.65±8.72) mg/dL, respectively. The three-hole group were (51.37±5.25) min, (3.25±0.35) mg/dL, (1 072.39±28.42) mg/dL, (193.08±10.35) mg/dL and (145.28±8.42) mg/dL, respectively, and those in the single-hole group were significantly higher than those in the three-hole group ( P<0.05). Conclusion:Under the premise of proficiency in surgical operation techniques, the single-port method reduces pain, reduces the use of analgesics, has less impact on immunological indicators, recovers gastrointestinal function faster, and has better postoperative abdominal wall cosmetic effects.