Clinical effect of transumbilical single-port laparoscopic cholecystectomy versus conventional three-trocar laparoscopic cholecystectomy with three holes: a comparative analysis / 临床肝胆病杂志

ABSTRACT

Objective To investigate the clinical effect of transumbilical single-port laparoscopic cholecystectomy versus conventional three -trocar conventional laparoscopic cholecystectomy.Methods A total of 62 patients with gallstones or gallbladder polyps who were admitted to Yan'an People's Hospital from January 2015 to December 2016 were enrolled,and according to the admission number,these patients were divided into three-trocar group with 32 patients treated with laparoscopic cholecystectomy with three holes and single-port group with 30 patients treated with single-port laparoscopic cholecystectomy.The two groups were compared in terms of time of operation,intraoperative blood loss,abdominal wall beauty score,Visual Analogue Scale (VAS) score before surgery and at 1 and 3 days after surgery,application of analgesics,levels of liver function parameters alanine aminotransferase (ALT),aspartate aminotransferase (AST),and alkaline phosphatase (ALP) before surgery and at 24 hours after surgery,hospital costs,and complications during the 1-month follow-up.The t-test was used for comparison of continuous data between groups,and the matched t-test was used for comparison before and after treatment.The chi-square test was used for comparison of categorical data between groups.Results Compared with the three-trocar group,the single-port group had a significantly higher abdominal wall beauty score after treatment (4.89 ±0.10 vs 3.15 ±0.34,t =4.910,P =0.039),a significantly shorter length of postoperative hospital stay (2.58 ±0.53 d vs 4.35 ±0.24 d,t =-5.459,P =0.032),a significantly longer time of operation (78.15 ±4.21 min vs 50.84 ±5.12 min,t =4.455,P =0.047),a significantly lower VAS score at 1 and 3 days after surgery (at 1 day after surgery4.72 ± 0.58 vs 6.37 ± 0.45,t =-7.060,P ＜ 0.001;at 3 days after surgery3.24 ± 0.83 vs 5.45 ± 0.94,t =-4.644,P ＜0.001),and a significantly lower proportion of patients who used analgesics (20.0％ vs 37.5％,x2 =6.768,P =0.009).Both groups had significant increases in the levels of ALT,AST,and ALP after surgery,and the single-port group had significantly lower levels than the three-trocar group (all P ＜ 0.001).During the 1-month follow-up,there was no significant difference in the incidence rate of complications between the two groups (P ＞ 0.05).Conclusion Transumbilical sing-port laparoscopic cholecystectomy has small surgical trauma and invisible scars after surgery.Patients feel little pain and are satisfied with the appearance of skin at the surgical site.This surgical procedure does not increase complications and has little influence on liver function.It needs a longer time of operation compared with three-trocar laparoscopic cholecystectomy.