The Clinical Application Analysis Of Modified Two-Hole Laparoscopic Cholecystectomy

Background: Laparoscpic cholecystectomy, first performed by Dr. Philipe Mouret in a human in 1987, has rapidly become established as the most popular method of gallbladder removal in the last 20 years. Compared with conventional open cholecystectomy, laparoscopic cholecystectomy provides shorter hospital stay, accelerated recovery, reduced incidence of major wound complications, and possibly reduced intraperitoneal adhesive complications. In many hospitals, LC has become"Golden standard"of surgical treatment in benign gallbladder diseases. In these years, with the experience of Surgeons continue to accumulate, the surgical techniques continuous improvement, and the related equipment continue to improvement. There have been attempts to minimize the invasiveness of laparoscopic cholecystectomy by reducing the size and/or the number of the operating ports. Conventional LC has already been development to the three holes, and some scholar are try to change the LC to two holes.Objective:To compare the postoperative quality of life between the three-hole and two-hole LC groups, study the clinical application of modified two-hole LC for exploring new micro-injury LC methods.Methods:Clinical records of 176 patients with calculus cholecystitis and polypus of cholecyst were treated with modified two-hole LC from October 2007 to October 2008. We reviewed these cases and compared with those of 208 cases treated by three-hole LC in the same period under the following parameters: operation time, blood loss, postoperative recovery and the days of hospital stay.Result:The total were 382 cases, 176 cases were carried by modified two-hole LC(2 cases were changed for three-hole LC during the operations), others were carried by three-hole LC. All of these patients'operation were successfully completed. There were no complication and conversion. The average time of operation was (three-hole LC 25.3±4.9, modified two-hole LC 27.8±7.1)min. The average blood loss in operation was(three-hole LC 19.0±6.5, modified two-hole LC 21.5±4.6)milliliter. The average out-of-bed activity time was(three-hole LC 10.2±3.8, modified two-hole LC 11.5±4.3)hour. The average hospitalized stays was(three-hole LC 2.7±0.8, modified two-hole LC 2.9±0.5)day. From the study we learn that there was not identify statistically significant differences between the three-hole LC and modified two-hole LC in these clinical guidelines(P>0.05).Conclusions:The application of modified two-hole LC is safe, effective on the premise of the well-operating of LC. It can reduce the injury to patients and advance the technique of micro-injury further.