Application Of Single-Site Laparoscopic Cholecystectomy In Patients With Abdominal Operation History

Objective:Surgery is a routine and effective surgical treatment for many diseases,but at the same time,it can also lead to a certain degree of damage to the body.Today,most abdominal operations can be performed under laparoscopy,and laparoscopic surgery is a milestone in reducing trauma in abdominal surgery.Since the 21 st century,For patients with a history of abdominal surgery,minimally invasive reoperation has become an urgent problem for surgeons.The purpose of this paper is to gate application advantagto investies and operational skills of establishment of pneumoperitoneum by hasson method and SSLC in patients with history of abdominal surgery.Methods:The clinical data of 221 patients undergoing laparoscopic cholecystectomy in the same group of patients with abdominal operation history in our hospital from October2011 to October 2018 were collected.The patients were divided into SSLC group(n =117)and LC group(n = 104)according to different operation styles.The time of operation,the amount of bleeding during the operation,the recovery time of digestive function,the postoperative pain score,the postoperative hospital stay,the beauty of the incision and the rate of conversion to laparotomy were analyzed statistically.Results:In the SSLC group,113 cases completed the operation successfully,and 4 cases were unable to reveal the gallbladder triangle to open because of the serious adhesion in the abdominal cavity.Among 104 patients in the LC group,101 patients successfully completed the operation and 3 patients were converted to laparotomy due to severeabdominal adhesion.Operation Time: SSLC group was(74.28 ±14.21)min,LC group was(67.58 ±13.61)min,which was less than SSLC group(P < 0.05).The amount of intraoperative blood loss: there was no significant difference in hospitalization time between the two groups in the SSLC group(13.61 ±1.48)ml,LC group(14.20 ±1.43)ml,(P > 0.05).The recovery of digestive function after operation was(14.41 ±2.63)h in SSLC group and(16.30 ±2.64)h in LC group;The postoperative hospital stay was(2.58 ±1.01)days in the SSLC group and(2.98 ±0.75)days in the LC group,and the pain score 24 hours after operation was(3.51 ±0.63)min in the SSLC group and(4.16± 0.43)min in the LC group;Incision beauty was(8.51 ± 0.84)in SSLC group and(7.87 ±0.73)in the LC group.The above clinical effect of the SSLC group was better than that of the LC group.(P < 0.05).The patients recovered well after operation,the incision healed beautifully and hidden,and there was no abdominal organ omentum injury and related common complications.Conclusion:Compared with LC,SSLC has no significant difference in safety and feasibility in the treatment of benign gallbladder diseases complicated with abdominal surgery,although the operation time is longer,and there is no significant difference in the safety and feasibility of SSLC.Moreover,postoperative pain was mild,gastrointestinal function recovered quickly and incision healing was beautiful.The key factors for the success of SSLC after abdominal surgery include careful evaluation of intraperitoneal adhesion,localization of operating channels and successful establishment of pneumoperitoneum by hasson method,separation of abdominal adhesion and dissection of gallbladder triangle.SSLC is a safe,feasible and minimally invasive surgical treatment for patients with benign diseases of gallbladder with abdominal operation history.