Value of laparoscopic cholecystectomy through the superior margin of public symphysis approach / 中华消化外科杂志

ABSTRACT

Objective To investigate the value of laparoscopic cholecystectomy through superior margin of public symphysis approach.Methods The clinical data of 72 patients with benign gallbladder diseases who were admitted to the Lihuili Hospital from December 2012 to August 2013 were retrospectively analyzed.There were 54 patients with cholecystolithiasis and 18 with gallbladder polyps.Thirty patients received laparoscopic cholecystectomy through the superior margin of public symphysis approach (new method group).Forty-two patients who received transumbilical single-port laparoscopic cholecystectomy were in the control group.The operation time,intraoperative blood loss,duration of postoperative hospital stay,degree of postoperative pain and cosmetic effect of the 2 groups were compared.Patients were followed up via out-patient examination and phone call till December 2013.Data were analyzed using the t test or chi-square test.Results Two patients in the new method group and 1 patient in the control group were converted to receive traditional laparoscopic cholecystectomy.The operation time,intraoperative blood loss,duration of postoperative hospital stay,scores of satisfaction with the incision and degree of postoperative pain were (28 ± 3) minutes,(23 ± 10) mL,(2.0 ± 0.5) days,4.3 ± 0.5 and 5.8 ± 0.8 in the new method group,and (39±4)minutes,(24±l0)mL,(2.0±0.6)days,3.9±0.5 and 5.9±0.9 in the control group.There were significant differences in the operation time and score of satisfaction with the incision between the 2 groups were detected (t =10.032,2.423,P ＜ 0.05),while no significant differences in the volume of intraoperative blood loss,duration of postoperative hospital stay and degree of pain between the 2 groups (t =1.021,0.000,1.760,P ＞ 0.05).All the patients were recovered,and were administered with semi-fluid food at postoperative day 2.No bleeding,bile leakage,incisional infection occurred,and no patient died perioperatively.Analgesics were not needed in the 2 groups.All the patients were followed up for 1-6 months.Patients were satisfied with the cosmetic appearance of the incision,and no inflammation,pain and infection of the incision occurred.Conclusions Laparoscopic cholecystectomy through the superior margin of public symphysis approach is safe and feasible,with the advantages of short operation time,cosmetic appearance of incision and easy manipulation.