Comparative Study Of Conventional And Transumbilical Laparoscopic Cholecystectomy

Objective： Gallstones is a General Surgery commondisease.China’s population’s gallstone prevalence rate of0.9-10.1%,it washigher In women and positively correlated with age.With the social andeconomic development, the incidence of gallstone is rising year byyear.The gallstones can sustainably exist for many years without obviousclinical symptoms, some found only because the physical examination byaccident.In the time of disease onset，Typical biliary colic is often the firstmanifestation，the pain often located in the right upper quadrant,sometimes in the upper abdomen， expressed as of persistent painassociated with intermittent heavier, and may be accompanied by fever,nausea, vomiting and other gastrointestinal symptoms, and the pain oftenradiation to the right shoulder back and vests. Patients in remission oftenwithout special signs and in the onset time have right upper quadranttenderness.If occurrence of serious complications such as gallbladderperforation, there often are rebound tenderness, muscle tension and othersigns of peritonitis.Joint symptoms, signs, and abdominal ultrasonography,gallstone basic can confirm the diagnosis.Gallstone the past hadLitholysis, gravel and other conservative treatment measures, but atpresent surgical resection is still the preferred method of treatment thedisease.With the development of minimally invasive surgery,laparoscopic cholecystectomy has become the gold standard of treatment of benigngallbladder disease in the medical profession.And through manylaparoscopic specialist’s exploration,it has generated many surgicalapproach,such as Classic four-hole method， Traditional three-holemethod，Natural Orifice Transluminal Endoscopic Surgery（transumbilicalthree holes，transumbilical single hole，Transrectal，Transvaginal etc.），Gasless and so on.These surgical methods have their respectiveadvantages and disadvantages.But in essence,They all try to pursueminimally invasive cosmetic results as much as possible.Because ofTransumbilical laparoscopic surgery avoided many problems such asequipment operating direction difficulty in celiac，abdominal infection，closed difficulties and so on due to use other natural orifice (rectum,vagina), and make full use of the umbilical skin occult scar characteristics,it was respected by the majority of endoscopy doctors and has becomeone of the surgical procedures currently exploring more. The purpose ofthis study is to further study transumbilical laparoscopic cholecystectomyof the advantages and feasibility, by contrasting the differences discussedfewer in the past between the traditional three-hole laparoscopic and thetransumbilical three-hole laparoscopic.It can accumulate some materialsfor how to select surgical approach of laparoscopic cholecystectomy.Method:40cases of gallbladder stones were randomly divided into thetransumbilical three-hole group and traditional three-hole group,20patients in each,Undergo respectively the traditional three-hole laparoscopic cholecystectomy and the transumbilical three-holelaparoscopic cholecystectomy by the same group doctors.Observe thetwo groups indicators including operative time, blood loss, intestinalfunction recovery time, nausea and vomiting rating, pain score, fatiguescore, the degree of the body trauma and do statistical treatment for thecorresponding data obtained.Results: Traditional three-hole group andtransumbilical three-hole group a total of40cases were successfullycompleted,none of the half-way transit into laparotomy or auxiliaryhole.Two groups in operative time, blood loss, intestinal functionrecovery time, within24hours of nausea and vomiting rating, fatiguescore, length of stay, hospital costs, trauma markers were not statisticallydifferent（P>0.05),There are statistical significance in pain score andbeauty ratings （P<0.05)， And a huge difference in the beauty ratings（P<0.01）.Conclusion: transumbilical laparoscopic cholecystectomy isfeasible and safe, it is able to achieve the same therapeutic effect with theconventional laparoscopic cholecystectomy and its abdominal wallcosmetic effect is more pronounced, patients with a higher degree ofrecognition.