• 南京醫(yī)科大學(xué)附屬無錫市人民醫(yī)院肝膽外科( 江蘇無錫 214000);

目的 　探討兩孔腹腔鏡膽囊切除術(shù)（LC）的安全性、可行性及優(yōu)勢。
方法 　回顧性分析2008年6月至2010年10月期間無錫市人民醫(yī)院開展的兩人兩孔LC（兩孔LC組，n=46）及同期完成的兩人三孔LC（三孔LC組，n=68）膽囊結(jié)石患者的臨床資料，比較2組的手術(shù)時(shí)間、術(shù)中出血量、術(shù)后進(jìn)食時(shí)間、術(shù)后疼痛評分、術(shù)后住院時(shí)間及總住院費(fèi)用。
結(jié)果 　114例患者手術(shù)均獲成功，術(shù)中、術(shù)后無并發(fā)癥發(fā)生。兩孔LC組的手術(shù)時(shí)間明顯長于三孔LC組（P＜0.05）；2組的術(shù)中出血量、術(shù)后進(jìn)食時(shí)間、術(shù)后疼痛評分及術(shù)后住院時(shí)間比較差異均無統(tǒng)計(jì)學(xué)意義（P＞0.05）；兩孔LC組的住院費(fèi)用明顯低于三孔LC組（P＜0.05）。
結(jié)論 　兩人兩孔LC在單純膽囊結(jié)石病例安全、可行，總住院費(fèi)用低于兩人三孔LC；在膽囊結(jié)石合并急性膽囊炎病例，因視野及操作均受限，應(yīng)謹(jǐn)慎開展。

引用本文： 趙建國,孫力,邱斌,蔡兵. 兩孔腹腔鏡膽囊切除術(shù)的探討. 中國普外基礎(chǔ)與臨床雜志, 2012, 19(2): 200-203. doi: 復(fù)制

1. Rupp CC，F(xiàn)arrell TM，Meyer AA．Single incision laparoscopic cholecystectomy using a “two-port” technique is safe and feasible： experience in 101 consecutive patients[J]．Am Surg，2011， 77(7）：916-921．.
2. Poon CM，Chan KW，Lee DW，et al．Two-port versus four port laparoscopic cholecystectomy[J]．Surg Endosc，2003，17(10)： 1624-1627．.
3. Bhattacharya K，Cathrine N．Two port laparoscopic cholecystectomy[J]．Trop Gastroenterol，2000，21(3)：149．.
4. Lee KW，Poon CM，Leung KF，et al．Two-port needlescopic cholecystectomy：prospective study of 100 cases[J]．Hong Kong Med J，2005，11(1)：30-35．.
5. Rao PP，Bhagwat SM，Rane A，et al．The feasibility of single port laparoscopic cholecystectomy：a pilot study of 20 cases[J]． HPB (Oxford)，2008，10(5)：336-340．.
6. Belli G，F(xiàn)antini C，D’agostino A，et al．Single port laparoscopic cholecystectomy：a new evolving technique[J]．Hepatogastroenterology，2011，58(109)：1132-1136．.
7. Torda TA，Pybus DA．Extradural administration of morphine and bupivacaine．A controlled comparison[J]．Br J Anaesth，1984， 56(2)：141-146．.
8. Saccomani G，Arezzo A，Percivale A，et al．Laparoscopic cholecystectomy can be performed safely with only three ports in the majority of cases[J]． Chir Ital，2009，61(5-6)：613-616．.
9. Langwieler TE，Nimmesgern T，Back M．Single-port access in laparoscopic cholecystectomy[J]．Surg Endosc，2009，23(5)： 1138-1141．.
10. Chalkoo M，Ahangar S，Durrani AM．Is fourth port really required in laparoscopic cholecystectomy?[J]．Indian J Surg， 2010，72(5)：373-376．.
11. Misiak A，Szczepanik AB．Laparoscopic cholecystectomy with single incision laparoscopic surgery[J]．Pol Merkur Lekarski， 2009，27(161)：372-374．.
12. Osborne DA，Alexander G，Boe B，et al．Laparoscopic cholecystectomy：past，present，and future[J]．Surg Technol Int， 2006，15：81-85．.
13. Al-Azawi D，Houssein N，Rayis AB，et al．Three-port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis[J]．BMC Surg，2007，7：8-14．.
14. Nguyen NT，Reavis KM，Hinojosa MW，et al．Laparoscopic transumbilical cholecystectomy without visible abdominal scars[J]．J Gastrointest Surg，2009，13(6)：1125-1128．.
15. Waqar SH，Shah SF，Khan IA，et al．Two-port laparoscopic cholecystectomy－a new technique[J]．J Ayub Med Coll Abbottabad，2008，20(4)：167-168．.
16. Caravati F，Ceriani F，Moroni M，et al．Laparoscopic cholecystectomy with three trocars：10 years experience[J]．Chir Ital， 2004，56(1)：81-88．.
17. Tebala GD．Three-port laparoscopic suture-suspension cholecystectomy[J]．Chir Ital，2008，60(2)：285-289．.
18. Shimura T，Suehiro T，Suzuki H，et al．Laparoscopic cholecystectomy using a novel two-port technique for surgical residency training[J]． Int Surg，2009，94(2)：149-153．.
19. Kumar M，Agrawal CS，Gupta RK．Three-port versus standard four-port laparoscopic cholecystectomy：a randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal[J]．JSLS，2007，11(3)：358-362．.
20. Tacchino R，Greco F，Matera D．Single-incision laparoscopic cholecystectomy：surgery without a visible scar[J]．Surg Endosc，2009，23(4)：896-899．.
21. Vidal O，Valentini M，Espert JJ，et al．Laparoendoscopic single-site cholecystectomy：a safe and reproducible alternative[J]．J Laparoendosc Adv Surg Tech A，2009，19(5)：599-602．.
22. Dutta S．Early experience with single incision laparoscopic surgery：eliminating the scar from abdominal operations[J]．J Pediatr Surg，2009，44(9)：1741-1745．.
23. Rivas H，Varela E，Scott D．Single-incision laparoscopic cholecystectomy：initial evaluation of a large series of patients[J]． Surg Endosc，2010，24(6)：1403-1412．.
24. Bucher P，Pugin F ，Buchs NC，et al．Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy[J]．Br J Surg，2011，98(12)：1695-1702．.
  1. 1. Rupp CC，F(xiàn)arrell TM，Meyer AA．Single incision laparoscopic cholecystectomy using a “two-port” technique is safe and feasible： experience in 101 consecutive patients[J]．Am Surg，2011， 77(7）：916-921．.
  2. 2. Poon CM，Chan KW，Lee DW，et al．Two-port versus four port laparoscopic cholecystectomy[J]．Surg Endosc，2003，17(10)： 1624-1627．.
  3. 3. Bhattacharya K，Cathrine N．Two port laparoscopic cholecystectomy[J]．Trop Gastroenterol，2000，21(3)：149．.
  4. 4. Lee KW，Poon CM，Leung KF，et al．Two-port needlescopic cholecystectomy：prospective study of 100 cases[J]．Hong Kong Med J，2005，11(1)：30-35．.
  5. 5. Rao PP，Bhagwat SM，Rane A，et al．The feasibility of single port laparoscopic cholecystectomy：a pilot study of 20 cases[J]． HPB (Oxford)，2008，10(5)：336-340．.
  6. 6. Belli G，F(xiàn)antini C，D’agostino A，et al．Single port laparoscopic cholecystectomy：a new evolving technique[J]．Hepatogastroenterology，2011，58(109)：1132-1136．.
  7. 7. Torda TA，Pybus DA．Extradural administration of morphine and bupivacaine．A controlled comparison[J]．Br J Anaesth，1984， 56(2)：141-146．.
  8. 8. Saccomani G，Arezzo A，Percivale A，et al．Laparoscopic cholecystectomy can be performed safely with only three ports in the majority of cases[J]． Chir Ital，2009，61(5-6)：613-616．.
  9. 9. Langwieler TE，Nimmesgern T，Back M．Single-port access in laparoscopic cholecystectomy[J]．Surg Endosc，2009，23(5)： 1138-1141．.
  10. 10. Chalkoo M，Ahangar S，Durrani AM．Is fourth port really required in laparoscopic cholecystectomy?[J]．Indian J Surg， 2010，72(5)：373-376．.
  11. 11. Misiak A，Szczepanik AB．Laparoscopic cholecystectomy with single incision laparoscopic surgery[J]．Pol Merkur Lekarski， 2009，27(161)：372-374．.
  12. 12. Osborne DA，Alexander G，Boe B，et al．Laparoscopic cholecystectomy：past，present，and future[J]．Surg Technol Int， 2006，15：81-85．.
  13. 13. Al-Azawi D，Houssein N，Rayis AB，et al．Three-port versus four-port laparoscopic cholecystectomy in acute and chronic cholecystitis[J]．BMC Surg，2007，7：8-14．.
  14. 14. Nguyen NT，Reavis KM，Hinojosa MW，et al．Laparoscopic transumbilical cholecystectomy without visible abdominal scars[J]．J Gastrointest Surg，2009，13(6)：1125-1128．.
  15. 15. Waqar SH，Shah SF，Khan IA，et al．Two-port laparoscopic cholecystectomy－a new technique[J]．J Ayub Med Coll Abbottabad，2008，20(4)：167-168．.
  16. 16. Caravati F，Ceriani F，Moroni M，et al．Laparoscopic cholecystectomy with three trocars：10 years experience[J]．Chir Ital， 2004，56(1)：81-88．.
  17. 17. Tebala GD．Three-port laparoscopic suture-suspension cholecystectomy[J]．Chir Ital，2008，60(2)：285-289．.
  18. 18. Shimura T，Suehiro T，Suzuki H，et al．Laparoscopic cholecystectomy using a novel two-port technique for surgical residency training[J]． Int Surg，2009，94(2)：149-153．.
  19. 19. Kumar M，Agrawal CS，Gupta RK．Three-port versus standard four-port laparoscopic cholecystectomy：a randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal[J]．JSLS，2007，11(3)：358-362．.
  20. 20. Tacchino R，Greco F，Matera D．Single-incision laparoscopic cholecystectomy：surgery without a visible scar[J]．Surg Endosc，2009，23(4)：896-899．.
  21. 21. Vidal O，Valentini M，Espert JJ，et al．Laparoendoscopic single-site cholecystectomy：a safe and reproducible alternative[J]．J Laparoendosc Adv Surg Tech A，2009，19(5)：599-602．.
  22. 22. Dutta S．Early experience with single incision laparoscopic surgery：eliminating the scar from abdominal operations[J]．J Pediatr Surg，2009，44(9)：1741-1745．.
  23. 23. Rivas H，Varela E，Scott D．Single-incision laparoscopic cholecystectomy：initial evaluation of a large series of patients[J]． Surg Endosc，2010，24(6)：1403-1412．.
  24. 24. Bucher P，Pugin F ，Buchs NC，et al．Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy[J]．Br J Surg，2011，98(12)：1695-1702．.