Clinical Application Of The Laparoscopic Cholecystectomy Through The Superior Of Public Symphysis Approach

Objective:To investigate the feasibility，security and practical evaluation of clinical applicationof the laparoscopic cholecystectomy through the superior of public symphysis approach.Methods:The clinical date of30patients with benigh gallbladder diseases who were admittedto the Lihuili Hospital from December2012to August2013were retrospectivelyanalyzed.Therewere24patients with cholecystolithiasis and6with gallbladder polyps.Allthe30patients received laparoscopic cholecystectomy through the superior of publicsymphysis approach(A group).Fourty-two patients (including30patients withcholecystolithiasis and12with gallbladder polyps)who received transumbilicalsingle-port laparoscopic cholecystectomy were in the control group.the operation time,intraoperative blood loss, postoperative hospital stay,degree of the postoperative pain,the total cost and cosmetic effect of the2groups were compared. Patients were followedup via out-patients examnation and phone call till December2013.Date was made bySPSS17.0software with the t test or χ2test and Wilcoxon test between groups.Results：30cases of Low incision laparoscopic cholecystectomy and42cases oftransumbilical single-port laparoscopic cholecystectomy fit for the requests of this studywere collected. It showd that72cases were successful.2cases in the group A totraditional LC,1case in other group transformed to traditional LC. No complicationsoccurred. There was no distinct difference in intraoperative blood loss in these twogroups(p>0.05); while there was difference between them in operation time, and (p <0.05),so there is statistically significance; Postoperative incision pain degree in the groupA is lighter than the other group, but there was no statistically significant difference (p>0.05); A group of postoperative patients satisfaction degree was better than that in thegroup with umbilical one trocar laparoscopic cholecystectomy method, and there wasstatistically significant difference (p <0.05); No significant difference in postoperative hospital stays and the total cost in these two groups (p>0.05). All the patients wererecovered,andwereadministeredwithsemi-fluid day2. no bleeding,bile leakage,incinsionalinfection were occurred and no patient died perioperatively.Analgesics were not neededin the2groups.All the patients were followed up for1-6months.Patients weresatisfactory with the cosmetic oppearance of the incision,and no inflammation,pain andincison occurred.Conclusion：It is feasible and safe to do the laparoscopic cholecystectomy through the superior ofpublic symphysis approach,furthermore, postoperative scar is not obvious, compared withtransumbilical single-port laparoscopic cholecystectomy,patients were more satisfactory,and there is a shorter operation time after surgery and easy to operate,which provides anew surgical approach and thinking for a more minimally invasive development oflaparoscopic surgery.