Application Of TU-LESS In Department Of Hepatobiliary Surgery

Objective:By comparing the clinical data of patients with benign disease of liver and gallbladder treated by laparoendoscopic single-site surgery(LESS) and conventional laparoscopic surgery, verification and analysis of the safety and efficacy of laparoendoscopic single-site surgery in the treatment of the diseases in this field. To study the advantages and disadvantages of LESS technology in the treatment of benign disease of liver and gallbladder, further broaden the scope of application of LESS surgery in the Department of Hepatobiliary Surgery. Emphasis is on the application of the treatment of gallbladder diseases, to play its application value and improve the quality of surgery. Methods:A total of 226 operation cases operated by the same surgery team in the fileld of liver and gallbladder surgery were collected in the First Affiliated Hospital of Shanxi Medical University general surgery from December 2013 to September 2015. 154 cases were treated by umbilical single port laparoscopic cholecystectomy(experimental group A), 47 cases of conventional laparoscopic cholecystectomy(control group A); After screening, the experimental group A retention of 154 cases, 47 cases of the control group were all retained.25 cases of hepatic cyst drainage were collected, including 15 cases of single port laparoscopic liver cyst drainage(experimental group B), 10 cases of conventional laparoscopic liver cyst drainage(control group B). All the operations were introduced in detail to the patients before operation, to ensure that each patient has the right to choose the operation mode, the experimental group patients are clear selection of single hole laparoscopic surgery. To summarize the clinical data of the patients, analysis of operation time, intraoperative hemorrhage, postoperative pain(VAS), gastrointestinal recovery time, postoperative complication rate, hospitalization time and cost of hospitalization and other indicators, finally discuss the feasibility of transumbilical single port laparoscopic surgery in the gallbladder excision operation and hepatic cyst unroofing surgery. Results:5 cases with the history of abdominal surgery were successfully completed surgery.In the154 cases of single hole laparoscopic cholecystectomy, 2 cases were found to have severe adhesions, and the anatomy of the triangle of the gallbladder is not clear and perform conversion to open surgery. In 1 case, because of the acute inflammation of the gallbladder, gallbladder wall thickness and large volume, resulting in poor traction effect. So on the right side of the abdominal wall to increase the operation of the hole, and ultimately successful completion of surgery, the remaining cases were successfully completed. In 47 cases of conventional laparoscopic cholecystectomy, 1 cases were converted to open surgery. In 25 cases of liver cyst fenestration cases, In addition to 1 cases of right posterior lobe of the liver cyst is huge, the position is too deep, leading to the laparoscopic instrument can not be detected, and the operation is difficult, so as to open surgery. The remaining cases were successfully completed. The operation time, bleeding loss, gastrointestinal recovery time and postoperative complication rate were compared between the groups, there was no statistical difference(P>0.05). The experimental group was superior to the control group(P<0.05) in the postoperative pain(VAS), the length of stay and hospital costs. Conclusion:Compared with the conventional laparoscopic technique, the single port laparoscopic technique is effective and feasible in the treatment of benign gallbladder disease and hepatic cyst. TU-LESS surgery has a significant advantage in patients with a history of abdominal surgery.The LESS technique difficulty is a little bit higher, with the accumulation of operation experience and improvement of operative technique, but single hole laparoscopic surgery without significantly prolonged and has less postoperative pain, advantage in the cost of hospitalization, hospitalization time, no abdominal scar. TU-LESS surgery is safe and feasible in the treatment of benign lesions of gallbladder and hepatic cysts.,which makes it has an obvious promotion value.