Feasibility study of single incision laparoscopic cholecystectomy in the treatment of acute cholecystitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LI Furong , NIU Fuyong

Department of Hepatobiliary Surgery, The First Hospital of Yulin, Yulin, Shaanxi 719000, P.R.China;

Corresponding?author：

LI Furong, Email: lifurong1983a@163.com

Keywords：

acute cholecystitis; single incision; three incisions; laparoscopic cholecystectomy; effectiveness

DOI：

10.7507/1007-9424.201612050

Video：

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Objective To explore the feasibility of single incision laparoscopic cholecystectomy in the treatment of acute cholecystitis, and to provide evidence based medicine for clinical treatment. Methods A total of 160 cases of acute cholecystitis who received treatment in our hospital from Jan. 2012 to Dec. 2015 were randomly divided into single incision group (n=80, received single incision laparoscopic cholecystectomy) and three incisions group (n=80, received three incisions laparoscopic cholecystectomy). The clinical and laboratory indexes were compared between the 2 groups. Results Compared with the three incisions group, there were statistically significant differences in the operation time, incision pain score, and subjective satisfaction, which were better in single incision group (P<0.05). But there was no significant difference in the blood loss, bed time, anal exhaust time, recovery time of intestinal peristalsis, hospitalization time, incidence of complication (including abdominal infection, bile duct injury, biliary fistula, and incision infection), ratios of T cell subsets (including CD3, CD4, and CD8 T cell), levels of immunoglobulin (including IgA, IgG, and IgM), and level of C reactive protein (P>0.05). Conclusions The effectiveness of single incision laparoscopic cholecystectomy is as good as three incisions laparoscopic cholecystectomy, but this single incision laparoscopic surgery is difficult, and its indications should be cautious. Single incision laparoscopic cholecystectomy is more suitable for patients undergoing elective cholecystectomy.

Citation： LI Furong, NIU Fuyong. Feasibility study of single incision laparoscopic cholecystectomy in the treatment of acute cholecystitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(6): 722-726. doi: 10.7507/1007-9424.201612050 Copy

1.	劉魯榮, 韓明子. 超聲引導下膽囊穿刺術治療急性膽囊炎概述. 中華臨床醫師雜志(電子版), 2016, 1(11): 308-309.
2.	劉鵬, 袁偉升, 宮琳, 等. 經皮經肝膽囊穿刺置管引流治療高齡危重急性膽囊炎. 實用醫藥雜志, 2016, 33(5): 407-409.
3.	Cao AM, Eslick GD, Nagaraja V, et al. Erratum to: early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case-control studies. Surg Endosc, 2016, 30(3): 1183.
4.	Cox TC, Huntington CR, Blair LJ, et al. Laparoscopic appendectomy and cholecystectomy versus open: a study in 1 999 pregnant patients. Surg Endosc, 2016, 30(2): 593-602.
5.	Murata A, Okamoto K, Muramatsu K, et al. Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database. J Surg Res, 2014, 186(1): 157-163.
6.	麻忠武, 陳峰, 徐邁宇, 等. 經臍單孔與三孔法腹腔鏡膽囊、闌尾聯合切除的對比研究. 中國微創外科雜志, 2014, 14(10): 900-902.
7.	中華醫學會外科學分會膽道外科學組. 急性膽道系統感染的診斷和治療指南 (2011 版). 中華消化外科雜志, 2011, 10(1): 9-13.
8.	Sato N, Kohi S, Tamura T, et al. Single-incision laparoscopic cholecystectomy for acute cholecystitis: a retrospective cohort study of 52 consecutive patients. Int J Surg, 2015, 17: 48-53.
9.	Chuang SH, Chen PH, Chang CM, et al. Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis. World J Gastroenterol, 2013, 19(43): 7743-7750.
10.	Avery KN, Metcalfe C, Nicklin J, et al. Satisfaction with care: an independent outcome measure in surgical oncology. Ann Surg Oncol, 2006, 13(6): 817-822.
11.	Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg, 1997, 84(5): 695.
12.	張忠濤, 韓威, 李建設, 等. 經臍單孔腹腔鏡膽囊切除術 1 例報告. 腹腔鏡外科雜志, 2008, 13(4): 314.
13.	許軍, 趙磊, 徐力善, 等. 不同器械經臍單切口與三孔腹腔鏡膽囊切除術的前瞻性隨機對照研究. 中國微創外科雜志, 2014, 20(1): 38-42.
14.	宋洪亮, 賀亞東, 金肖丹, 等. 腹腔鏡逆行膽囊切除術 30 例臨床分析. 肝膽胰外科雜志, 2008, 20(4): 279-280.
15.	Ridker PM. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. Curr Atheroscler Rep, 2009, 359(4): 534-544.
16.	Tinhofer I, Weiss L, Gassner F, et al. Difference in the relative distribution of CD4⁺ T-cell subsets in B-CLL with mutated and unmutated immunoglobulin (Ig) VH genes: implication for the course of disease. J Immunother, 2009, 32(3): 302-309.
17.	楊愛國, 聶凱, 鄒耀祥. 膽囊三角區炎癥致密粘連時腹腔鏡切除膽囊方法的探討. 腹部外科, 2008, 21(4): 233-234.
18.	成陜林, 胡娟娟, 王新民. 腹腔鏡及開腹手術對膽囊切除后患者腸粘連的臨床療效比較. 中國醫藥導報, 2015, 12(3): 81-84.
19.	叢守會. 腹腔鏡手術治療急性膽囊炎的臨床體會 (附 47 例報告). 腹腔鏡外科雜志, 2016, 21(6): 447-449.
20.	Boyd B, Lee ER. Ultrasound of the gallbladder and biliary tree : back to basics. Ultrasound Clin, 2014, 9(4): 567-586.
21.	Colak Y, Bozbey G, Erim T, et al. Impaired gallbladder motility and increased gallbladder wall thickness in patients with nonalcoholic fatty liver disease. J Neurogastroenterol Motil, 2016, 22(3): 470-476.
22.	Motla M, Manaktala S, Gupta V, et al. Sonographic evidence of ascites, pleura-pericardial effusion and gallbladder wall edema for dengue fever. Prehosp Disaster Med, 2011, 26(5): 335-341.
23.	Mohammadi A, Ghasemirad M, Mohammadifar M. Differentiation of benign from malignant induced ascites by measuring gallbladder wall thickness. Maedica (Buchar), 2011, 6(4): 282-286.
24.	Shingu Y, Komatsu S, Norimizu S, et al. Laparoscopic subtotal cholecystectomy for severe cholecystitis. Surg Endosc, 2016, 30(2): 526-531.
25.	Pietrabissa A, Pugliese L, Vinci A, et al. Short-term outcomes of single-site robotic cholecystectomy versus four-port laparoscopic cholecystectomy: a prospective, randomized, double-blind trial. Surg Endosc, 2016, 30(7): 3089-3097.

1. 劉魯榮, 韓明子. 超聲引導下膽囊穿刺術治療急性膽囊炎概述. 中華臨床醫師雜志(電子版), 2016, 1(11): 308-309.
2. 劉鵬, 袁偉升, 宮琳, 等. 經皮經肝膽囊穿刺置管引流治療高齡危重急性膽囊炎. 實用醫藥雜志, 2016, 33(5): 407-409.
3. Cao AM, Eslick GD, Nagaraja V, et al. Erratum to: early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case-control studies. Surg Endosc, 2016, 30(3): 1183.
4. Cox TC, Huntington CR, Blair LJ, et al. Laparoscopic appendectomy and cholecystectomy versus open: a study in 1 999 pregnant patients. Surg Endosc, 2016, 30(2): 593-602.
5. Murata A, Okamoto K, Muramatsu K, et al. Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database. J Surg Res, 2014, 186(1): 157-163.
6. 麻忠武, 陳峰, 徐邁宇, 等. 經臍單孔與三孔法腹腔鏡膽囊、闌尾聯合切除的對比研究. 中國微創外科雜志, 2014, 14(10): 900-902.
7. 中華醫學會外科學分會膽道外科學組. 急性膽道系統感染的診斷和治療指南 (2011 版). 中華消化外科雜志, 2011, 10(1): 9-13.
8. Sato N, Kohi S, Tamura T, et al. Single-incision laparoscopic cholecystectomy for acute cholecystitis: a retrospective cohort study of 52 consecutive patients. Int J Surg, 2015, 17: 48-53.
9. Chuang SH, Chen PH, Chang CM, et al. Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis. World J Gastroenterol, 2013, 19(43): 7743-7750.
10. Avery KN, Metcalfe C, Nicklin J, et al. Satisfaction with care: an independent outcome measure in surgical oncology. Ann Surg Oncol, 2006, 13(6): 817-822.
11. Navarra G, Pozza E, Occhionorelli S, et al. One-wound laparoscopic cholecystectomy. Br J Surg, 1997, 84(5): 695.
12. 張忠濤, 韓威, 李建設, 等. 經臍單孔腹腔鏡膽囊切除術 1 例報告. 腹腔鏡外科雜志, 2008, 13(4): 314.
13. 許軍, 趙磊, 徐力善, 等. 不同器械經臍單切口與三孔腹腔鏡膽囊切除術的前瞻性隨機對照研究. 中國微創外科雜志, 2014, 20(1): 38-42.
14. 宋洪亮, 賀亞東, 金肖丹, 等. 腹腔鏡逆行膽囊切除術 30 例臨床分析. 肝膽胰外科雜志, 2008, 20(4): 279-280.
15. Ridker PM. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. Curr Atheroscler Rep, 2009, 359(4): 534-544.
16. Tinhofer I, Weiss L, Gassner F, et al. Difference in the relative distribution of CD4⁺ T-cell subsets in B-CLL with mutated and unmutated immunoglobulin (Ig) VH genes: implication for the course of disease. J Immunother, 2009, 32(3): 302-309.
17. 楊愛國, 聶凱, 鄒耀祥. 膽囊三角區炎癥致密粘連時腹腔鏡切除膽囊方法的探討. 腹部外科, 2008, 21(4): 233-234.
18. 成陜林, 胡娟娟, 王新民. 腹腔鏡及開腹手術對膽囊切除后患者腸粘連的臨床療效比較. 中國醫藥導報, 2015, 12(3): 81-84.
19. 叢守會. 腹腔鏡手術治療急性膽囊炎的臨床體會 (附 47 例報告). 腹腔鏡外科雜志, 2016, 21(6): 447-449.
20. Boyd B, Lee ER. Ultrasound of the gallbladder and biliary tree : back to basics. Ultrasound Clin, 2014, 9(4): 567-586.
21. Colak Y, Bozbey G, Erim T, et al. Impaired gallbladder motility and increased gallbladder wall thickness in patients with nonalcoholic fatty liver disease. J Neurogastroenterol Motil, 2016, 22(3): 470-476.
22. Motla M, Manaktala S, Gupta V, et al. Sonographic evidence of ascites, pleura-pericardial effusion and gallbladder wall edema for dengue fever. Prehosp Disaster Med, 2011, 26(5): 335-341.
23. Mohammadi A, Ghasemirad M, Mohammadifar M. Differentiation of benign from malignant induced ascites by measuring gallbladder wall thickness. Maedica (Buchar), 2011, 6(4): 282-286.
24. Shingu Y, Komatsu S, Norimizu S, et al. Laparoscopic subtotal cholecystectomy for severe cholecystitis. Surg Endosc, 2016, 30(2): 526-531.
25. Pietrabissa A, Pugliese L, Vinci A, et al. Short-term outcomes of single-site robotic cholecystectomy versus four-port laparoscopic cholecystectomy: a prospective, randomized, double-blind trial. Surg Endosc, 2016, 30(7): 3089-3097.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Feasibility study of single incision laparoscopic cholecystectomy in the treatment of acute cholecystitis

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