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目的探讨经脐单孔腹腔镜在治疗大面积烧伤合并急性胆囊炎患者的手术经验总结。方法回顾性分析58例经脐单孔行单孔腹腔镜行胆囊切除术的大面积腹部烧伤患者的临床资料。结果 5例因肥胖和胆囊坏疽,周围渗出严重,胆囊三角暴露不清,改为传统三孔腹腔镜完成手术,其余均成功行经脐单孔腹腔镜手术,成功率91.38%,手术时间50～130min,无术后手术切口裂开、切口疝、腹腔内出血、迷走胆瘘、腹腔内感染和胆道损伤等并发症发生,出院前胆囊炎均痊愈。结论经脐单孔腹腔镜治疗腹部大面积烧伤合并胆囊炎的方法大大减少患者手术切口裂开几率,同时减轻患者二重感染的几率,并且手术安全可行,具有微创、美观、疗效确切等优点。
Objective To investigate the surgical experience of transumbilical single-hole laparoscopy in the treatment of large-area burn with acute cholecystitis. Methods A retrospective analysis of 58 cases of single-hole laparoscopic cholecystectomy via abdominal umbilical single hole large abdominal burns patients clinical data. Results 5 cases of obesity and gallbladder gangrene, peripheral exudation, gallbladder triangle exposure is unclear, to the traditional three-hole laparoscopic surgery, the remaining successful single-hole umbilical laparoscopic surgery, the success rate of 91.38%, operative time 50 ~ 130min. There were no complications such as incision, incisional hernia, intraperitoneal hemorrhage, vagal fistula, intraperitoneal infection and biliary tract injury after operation, and cholecystitis was cured before discharge. Conclusion The single-hole laparoscopic transabdominal treatment of severe abdominal burn combined with cholecystitis greatly reduces the chances of incision in patients with surgical incision, while reducing the risk of double infection in patients, and safe and feasible operation, with minimally invasive, beautiful, the exact effect of such advantages .