关键词: 胆囊炎, 胆结石, 腹腔镜胆囊切除术, 单孔腔镜, 三孔腔镜, 应激反应, 胃肠道功能

Abstract:

Objective To analyze and compare the eff ects of single port laparoscopic cholecystectomy, triple port laparoscopic cholecystectomy, and open cholecystectomy in patients with cholecystitis and gallstones. Method A total of 93 patients with cholecystitis and gallstones who were treated in Yixing Integrated Traditional Chinese and Western Medicine Hospital from January 2022 to January 2024 were selected and included in the study. They were divided into three groups according to diff erent surgical forms, corresponding to open surgery group (31 cas-es), three port laparoscopic group (31 cases), and single port laparoscopic group (31 cases), and each group was treated with open cholecystectomy, three port laparoscopic cholecystectomy, and single port laparoscopic cholecys-tectomy. The perioperative indicators, stress response indicators, gastrointestinal function, and aesthetic degree were compared among the three groups. Result The surgical time and incision length of the three port endoscopy groupand the single port endoscopy group were lower than those of the open surgery group, and the intraoperative blood loss was lower than that of the open surgery group, with signifi cant diff erences (P ＜ 0.05); The levels of C-reactive protein, cortisol, and norepinephrine in the three port endoscopic group and the single port endoscopic group were all higher than those in the open surgery group, and the single port endoscopic group had signifi cantly higher levels of these three indicators than the three port endoscopic group (P ＜ 0.05); The gastric emptying rate, number of gastric antral contractions, and number of gastric body peristalsis in the three port endoscopic group and the single port endoscopic group were all higher than those in the open surgery group, and the above three indicators were all higher in the single port endoscopic group than in the three port endoscopic group (P ＜ 0.05); The postoperative aesthetic degree of the single hole endoscopic group was better than that of the three hole endoscopic group and the open surgery group (P ＜ 0.05). Conclusion Although small incision cholecystectomy and laparoscopic cholecys-tectomy have similar therapeutic eff ects, both can eff ectively treat cholecystitis with gallstones. However, compared to small incision cholecystectomy, laparoscopic cholecystectomy brings less trauma and better postoperative re-covery. Among them, the advantage of the single hole endoscopic group is more obvious, and not only does it have better postoperative recovery, but it also has higher aesthetic appeal.

Key words: Cholecystitis, Gallstone, Laparoscopic cholecystectomy, Single hole endoscope, Three hole endoscope, Stress response, Gastrointestinal function