Transumbilical Single-Port Laparoscopic Cholecystectomy in Treatment for Children Patients with Benign GallbladderDiseases （Report of 41 Cases）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Long , QIAN Jianjun , BAI Dousheng ,  YAO Jie , CHEN Ping

Department of Hepatobiliary Surgery， Clinical Medical College of Yangzhou University， Yangzhou 225001， Jiangsu Province， China;

Corresponding author：

YAO Jie, Email: docyao@126.com

Keywords：

Laparoscopic cholecystectomy; Transumbilical approach; Children; Benign gallbladder disease

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Objective 　To explore the feasibility， operation method， and clinical application value of transumbilical single-port laparoscopic cholecystectomy （TUSP-LC） in treatment for children patients with benign gallbladder diseases.
Methods 　The clinical data of 64 patients with benign gallbladder diseases from June 2009 to June 2011 were analyzed retrospectively. The patients were divided into TUSP-LC group （n=41） and convention three-port LC （CTP-LC group， n=23）. The operative time， intraoperative blood loss， conversion to CTP-LC or laparotomy， operative complications， and hospital stay were recorded. The pains were registered at 3，6，12，24，48， and 72h postoperatively using visual analog scale （VAS）. The patients were given satisfaction questionnaires with surgery at 6 time points （1 week， 2 weeks， 1 month， 3 months， 6 months， 12 months） during a 12 months follow-up.
Results 　A total of 64 pediatric LCs were performed successfully， no patients were converted to laparotomy. Except for one case of incision infection in the CTP-LC group 〔4.35%（1/23）〕 and one case of incision infection and one case of ecchymoma in the TUSP-LC group 〔4.88% （2/41）〕， no other complications such as bile duct injury， bile leakage， and incision hernia happened， the total complication rate was not significant difference in two groups （P＞0.05）. The operative time 〔（47.54±18.71） min versus（45.33±10.58） min〕， intraoperative blood loss 〔（18.56±13.34） ml versus （17.28±12.53） ml〕， and hospital stay 〔（1.67±0.36） d versus （1.81±0.38） d〕were not significant differences in two groups （P＞0.05）. The VAS score was not statisticly significant within 24h in two groups （P＞0.05）， but which in the TUSP-LC group was significantly lower than that in the CTP-LC group after 24h postoperatively （P＜0.05）. During a 12 months follow-up， the score of satisfaction in the TUSP-LC group was significantly higher than that in the CTP-LC group （P＜0.05）.
Conclusions 　TUSP-LC is a safe and feasible method in the children patients with benign gallbladder diseases. It can be performed with the same technical exposure and outcomes as multi-port laparoscopy， with the added benefit of relieving postoperative pain and little no scarring.

Citation： ZHAO Long,QIAN Jianjun,BAI Dousheng,YAO Jie,CHEN Ping,.. Transumbilical Single-Port Laparoscopic Cholecystectomy in Treatment for Children Patients with Benign GallbladderDiseases （Report of 41 Cases）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(2): 178-182. doi: Copy

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14.	郑小东，马海，杨红春. 腹腔镜胆囊切除术中Calot三角解剖的技巧[J]. 第三军医大学学报， 2006， 28(15)：1594-1594， 1600.
15.	王广伟，顾元龙，吴兴桂，等. 经脐单孔腹腔镜胆囊切除术与常规腹腔镜胆囊切除术的临床疗效比较[J]. 中国普外基础与临床杂志， 2011， 18(12)：1305-1308.
16.	吴文庆，刘玉林，李小华. 联合后-前胆囊三角入路在腹腔镜胆囊切除中的应用[J]. 中国普外基础与临床杂志， 2010， 17(11)： 1199-1200.
17.	Friesen CA， Roberts CC. Cholelithiasis. clinical characteristics in children. Case analysis and literature review[J]. Clin Pediatr (Phila)， 1989， 28(7)：294-298.
18.	Hernandez J， Ross S， Morton C， et al. The learning curve of laparoendoscopic single-site (LESS) cholecystectomy：definable， short， and safe[J]. J Am Coll Surg， 2010， 211(5)：652-657.
19.	Prasad A， Mukherjee KA， Kaul S， et al. Postoperative pain after cholecystectomy：Conventional laparoscopy versus single-incision laparoscopic surgery[J]. J Minim Access Surg， 2011， 7(1)：24-27.

1. Osborne DA， Alexander G， Boe B， et al. Laparoscopic cholecystectomy：past， present， and future[J]. Surg Technol Int， 2006， 15：81-85.
2. Navarra G， Pozza E， Occhionorelli S， et al. One-wound laparoscopic cholecystectomy[J]. Br J Surg， 1997， 84(5)：695.
3. Swain P， Bagga HS， Su LM. Status of endoscopes and instru-ments used during NOTES[J]. J Endourol， 2009， 23(5)：773-780.
4. Desai MM， Berger AK， Brandina R， et al. Laparoendoscopic single-site surgery：initial hundred patients[J]. Urology， 2009， 74(4)：805-812.
5. Frazee RC， Roberts JW， Okeson GC， et al. Open versus laparoscopic cholecystectomy. A comparison of postoperative pulmonary function[J]. Ann Surg， 1991， 213(6)：651-654.
6. Wewers ME， Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena[J]. Res Nurs Health， 1990， 13(4)：227-236.
7. Baird JF， Kiyak HA. The uninformed orthodontic patient and parent：treatment outcomes[J]. Am J Orthod DentofacialOrthop， 2003， 124(2)：212-215.
8. 胡孔旺，朱化刚. 儿童期胆囊结石27例临床诊疗分析[J]. 肝胆外科杂志， 2002， 10(1)：21-22.
9. Al-Salem AH， Nourallah H. Sequential endoscopic/laparoscopic management of cholelithiasis and choledocholithiasis in children who have sickle cell disease[J]. J Pediatr Surg， 1997， 32(10)：1432-1435.
10. Patton ML， Moss BE， Haith LR Jr， et al. Concomitant laparoscopic cholecystectomy and splenectomy for surgical management of hereditary spherocytosis[J]. Am Surg， 1997， 63(6)：536-539.
11. Tagge EP， Othersen HB Jr， Jackson SM， et al. Impact of laparoscopic cholecystectomy on the management of cholelithiasis in children with sickle cell disease[J]. J Pediatr Surg， 1994， 29(2)：209-213.
12. Kumar R， Nguyen K， Shun A. Gallstones and common bile duct calculi in infancy and childhood[J]. Aust N Z J Surg， 2000， 70(3)：188-191.
13. Schier F， Waldschmidt J. Laparoscopic fundoplication in a child[J]. Eur J Pediatr Surg， 1994， 4(6)：338-340.
14. 郑小东，马海，杨红春. 腹腔镜胆囊切除术中Calot三角解剖的技巧[J]. 第三军医大学学报， 2006， 28(15)：1594-1594， 1600.
15. 王广伟，顾元龙，吴兴桂，等. 经脐单孔腹腔镜胆囊切除术与常规腹腔镜胆囊切除术的临床疗效比较[J]. 中国普外基础与临床杂志， 2011， 18(12)：1305-1308.
16. 吴文庆，刘玉林，李小华. 联合后-前胆囊三角入路在腹腔镜胆囊切除中的应用[J]. 中国普外基础与临床杂志， 2010， 17(11)： 1199-1200.
17. Friesen CA， Roberts CC. Cholelithiasis. clinical characteristics in children. Case analysis and literature review[J]. Clin Pediatr (Phila)， 1989， 28(7)：294-298.
18. Hernandez J， Ross S， Morton C， et al. The learning curve of laparoendoscopic single-site (LESS) cholecystectomy：definable， short， and safe[J]. J Am Coll Surg， 2010， 211(5)：652-657.
19. Prasad A， Mukherjee KA， Kaul S， et al. Postoperative pain after cholecystectomy：Conventional laparoscopy versus single-incision laparoscopic surgery[J]. J Minim Access Surg， 2011， 7(1)：24-27.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Transumbilical Single-Port Laparoscopic Cholecystectomy in Treatment for Children Patients with Benign GallbladderDiseases （Report of 41 Cases）

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