单孔腹腔镜胆囊切除术中国专家共识（2024版）

中国研究型医院学会微创外科学专业委员会

doi:10.12449/JCH241007

单孔腹腔镜胆囊切除术中国专家共识（2024版）

DOI: 10.12449/JCH241007

中国研究型医院学会微创外科学专业委员会

利益冲突声明：本文不存在任何利益冲突。

计量
- 文章访问数: 634
- HTML全文浏览量: 99
- PDF下载量: 144
- 被引次数: 0
出版历程
- 收稿日期: 2024-09-10
- 录用日期: 2024-09-15
- 出版日期: 2024-10-25

Chinese expert consensus on single-incision laparoscopic cholecystectomy （2024 edition）

Minimally Invasive Surgery Committee of the Chinese Research Hospital Association

摘要

- 胆囊切除术，腹腔镜 /
- 共识 /
- 中国
- Cholecystectomy， Laparoscopic /
- Consensus /
- China

HTML全文

图 1 术者站位

Figure 1. Surgeon’s position

下载: 全尺寸图片幻灯片

表 1 证据质量评估及推荐强度分级

Table 1. Evaluation of evidence quality and classification of recommendation strength

分级	具体描述
证据质量分级
高（A）	非常有把握（观察值接近真实值）
中（B）	对观察值有中等把握（观察值有可能接近真实值，但亦有可能差别很大）
低（C）	对观察值的把握有限（观察值可能与真实值有较大差别）
极低（D）	对观察值几乎无把握（观察值与真实值可能有极大差别）
推荐强度分级
强	明确显示干预措施利大于弊，或弊大于利
弱	利弊不确定，或无论质量高低的证据均显示利弊相当

下载: 导出CSV

参考文献(52)

[1]	KIM SS, DONAHUE TR. Laparoscopic cholecystectomy[J]. JAMA, 2018, 319( 17): 1834. DOI: 10.1001/jama.2018.3438.
[2]	AGRESTA F, CAMPANILE FC, VETTORETTO N, et al. Laparoscopic cholecystectomy: Consensus conference-based guidelines[J]. Langenbecks Arch Surg, 2015, 400( 4): 429- 453. DOI: 10.1007/s00423-015-1300-4.
[3]	ELLATIF ME ABD, ASKAR WA, ABBAS AE, et al. Quality-of-life measures after single-access versus conventional laparoscopic cholecystectomy: A prospective randomized study[J]. Surg Endosc, 2013, 27( 6): 1896- 1906. DOI: 10.1007/s00464-012-2625-5.
[4]	BUCHER P, PUGIN F, BUCHS NC, et al. Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy[J]. Br J Surg, 2011, 98( 12): 1695- 1702. DOI: 10.1002/bjs.7689.
[5]	JØRGENSEN LN, ROSENBERG J, AL-TAYAR H, et al. Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy[J]. Br J Surg, 2014, 101( 4): 347- 355. DOI: 10.1002/bjs.9393.
[6]	SUN D, LIU SZ, ZHANG GY. Application of single-port laparoscopy in general surgery[J]. J Laparosc Surg, 2011, 16( 2): 149- 151. DOI: 10.3969/j.issn.1009-6612.2011.02.026. 孙栋, 刘少壮, 张光永. 单孔腹腔镜技术在普通外科的应用[J]. 腹腔镜外科杂志, 2011, 16( 2): 149- 151. DOI: 10.3969/j.issn.1009-6612.2011.02.026.
[7]	WANG D, WANG Y, JI ZL. Laparoendoscopic single-site cholecystectomy versus conventional laparoscopic cholecystectomy: A systematic review of randomized controlled trials[J]. ANZ J Surg, 2012, 82( 5): 303- 310. DOI: 10.1111/j.1445-2197.2012.06044.x.
[8]	KANG LM, ZHENG Y, SHI HN, et al. Comparative study of single-incision laparoscopic cholecystectomy and traditional laparoscopic cholecystectomy for acute cholecystitis[J]. J Laparosc Surg, 2017, 22( 11): 835- 838. DOI: 10.13499/j.cnki.fqjwkzz.2017.11.835. 康利民, 郑永, 施红宁, 等. 急性胆囊炎单孔腹腔镜胆囊切除术与传统腹腔镜手术的对比研究[J]. 腹腔镜外科杂志, 2017, 22( 11): 835- 838. DOI: 10.13499/j.cnki.fqjwkzz.2017.11.835.
[9]	GUYATT G, OXMAN AD, AKL EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables[J]. J Clin Epidemiol, 2011, 64( 4): 383- 394. DOI: 10.1016/j.jclinepi.2010.04.026.
[10]	MORALES-CONDE S, PEETERS A, MEYER YM, et al. European association for endoscopic surgery(EAES) consensus statement on single-incision endoscopic surgery[J]. Surg Endosc, 2019, 33( 4): 996- 1019. DOI: 10.1007/s00464-019-06693-2.
[11]	AREZZO A, PASSERA R, BULLANO A, et al. Multi-port versus single-port cholecystectomy: Results of a multi-centre, randomised controlled trial(MUSIC trial)[J]. Surg Endosc, 2017, 31( 7): 2872- 2880. DOI: 10.1007/s00464-016-5298-7.
[12]	PEREIRA C, GURURAJ S. A systematic review and meta-analysis of single-incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy[J]. Cureus, 2022, 14( 12): e32524. DOI: 10.7759/cureus.32524.
[13]	QIU ZJ, SUN J, PU Y, et al. Learning curve of transumbilical single incision laparoscopic cholecystectomy(SILS): A preliminary study of 80 selected patients with benign gallbladder diseases[J]. World J Surg, 2011, 35( 9): 2092- 2101. DOI: 10.1007/s00268-011-1144-1.
[14]	PAN MX, JIANG ZS, CHENG Y, et al. Single-incision vs three-port laparoscopic cholecystectomy: Prospective randomized study[J]. World J Gastroenterol, 2013, 19( 3): 394- 398. DOI: 10.3748/wjg.v19.i3.394.
[15]	WU XS, SHI LB, GU J, et al. Single-incision laparoscopic cholecystectomy versus multi-incision laparoscopic cholecystectomy: A meta-analysis of randomized clinical trials[J]. J Laparoendosc Adv Surg Tech A, 2013, 23( 3): 183- 191. DOI: 10.1089/lap.2012.0189.
[16]	LI XL, WU SD, HAN JY, et al. Clinical comparative study of single-hole laparoscopic cholecystectomy and three-hole laparoscopic cholecystectomy[J]. Chin J Curr Adv Gen Surg, 2012, 15( 12): 990- 991, 996. DOI: 10.3969/j.issn.1009-9905.2012.12.021. 李晓龙, 吴硕东, 韩金岩, 等. 单孔法与三孔腹腔镜胆囊切除术的临床对比研究[J]. 中国现代普通外科进展, 2012, 15( 12): 990- 991, 996. DOI: 10.3969/j.issn.1009-9905.2012.12.021.
[17]	ZHANG WX, HUANG AH, ZHU JF, et al. Laparoscopic endoscopic single-site cholecystectomy using TriPort[J/CD]. Chin J Laparosc Surg Electron Ed, 2011, 4( 3): 191- 195. DOI: 10.3877/cma.j.issn.1674-6899.2011.03.008. 张文新, 黄安华, 朱江帆, 等. 采用TriPort单孔腹腔镜胆囊切除术的临床研究[J/CD]. 中华腔镜外科杂志(电子版), 2011, 4( 3): 191- 195. DOI: 10.3877/cma.j.issn.1674-6899.2011.03.008.
[18]	ZHAO GD, XU DB, LIU R, et al. The clinical analysis of 24 cases of transumbilical single-incision laparoscopic cholecystectomy[J/CD]. Chin J Laparosc Surg Electron Ed, 2010, 3( 1): 113- 118. DOI: 10.3969/j.issn.1674-6899.2010.01.014. 赵国栋, 许大彬, 刘荣, 等. 经脐单孔腹腔镜胆囊切除临床分析[J/CD]. 中华腔镜外科杂志(电子版), 2010, 3( 1): 113- 118. DOI: 10.3969/j.issn.1674-6899.2010.01.014.
[19]	HU SY, ZHANG GY. The application of suspended transumbilical single port laparoscopic cholecystectomy[J/CD]. Chin J Laparosc Surg Electron Ed, 2009, 2( 1): 13- 15. DOI: 10.3969/j.issn.1674-6899.2009.01.004. 胡三元, 张光永. 悬吊式经脐单孔腹腔镜胆囊切除术[J/CD]. 中华腔镜外科杂志(电子版), 2009, 2( 1): 13- 15. DOI: 10.3969/j.issn.1674-6899.2009.01.004.
[20]	FU J, LIU YY, FAN Y, et al. A comparative study between modified transumbilical single-port laparoscopic cholecystetomy and traditional laparoscopic cholecystectomy[J]. Chin J Minim Invasive Surg, 2019, 19( 7): 606- 609. DOI: 10.3969/j.issn.1009-6604.2019.07.009. 伏洁, 刘永永, 樊勇, 等. 改良式经脐单孔腹腔镜与传统腹腔镜胆囊切除术的比较[J]. 中国微创外科杂志, 2019, 19( 7): 606- 609. DOI: 10.3969/j.issn.1009-6604.2019.07.009.
[21]	LIU N, ZHANG GY, HU SY. Gasless laparoendoscopic single-site cholecystectomy with abdominal wall lift: A trial compared with conventional laparoscopic cholecystectomy[J]. J Laparosc Surg, 2011, 16( 2): 95- 99. DOI: 10.3969/j.issn.1009-6612.2011.02.005. 刘南, 张光永, 胡三元. 悬吊式经脐单孔腹腔镜胆囊切除术与传统腹腔镜胆囊切除术的对比研究[J]. 腹腔镜外科杂志, 2011, 16( 2): 95- 99. DOI: 10.3969/j.issn.1009-6612.2011.02.005.
[22]	HAN W, ZHANG ZT, LI JS, et al. Transumbilicap single port access laparescopk cholecystectomy: A clinical report of 12 cases and review of the literatures[J]. Chin J Pract Surg, 2008, 28( 11): 967- 969. DOI: 10.3321/j.issn: 1005-2208.2008.11.022. 韩威, 张忠涛, 李建设, 等. 经脐单孔腹腔镜胆囊切除术(附12例报告及文献复习)[J]. 中国实用外科杂志, 2008, 28( 11): 967- 969. DOI: 10.3321/j.issn: 1005-2208.2008.11.022.
[23]	HAJONG R, HAJONG D, NATUNG T, et al. A comparative study of single incision versus conventional four ports laparoscopic cholecystectomy[J]. J Clin Diagn Res, 2016, 10( 10): PC06-PC 09. DOI: 10.7860/JCDR/2016/19982.8601.
[24]	GUO W, LIU Y, HAN W, et al. Randomized trial of immediate postoperative pain following single-incision versus traditional laparoscopic cholecystectomy[J]. Chin Med J, 2015, 128( 24): 3310- 3316. DOI: 10.4103/0366-6999.171422.
[25]	GUO W, ZHANG ZT, HAN W, et al. Transumbilical Single-Port laparoscopic cholecystectomy: Experience of 120 cases[J]. Chin J Pract Surg, 2010, 30( 4): 304- 306, 317. 郭伟, 张忠涛, 韩威, 等. 经脐单孔腹腔镜胆囊切除术120例回顾性分析[J]. 中国实用外科杂志, 2010, 30( 4): 304- 306, 317.
[26]	PICHÉ ME, TCHERNOF A, DESPRÉS JP. Obesity phenotypes, diabetes, and cardiovascular diseases[J]. Circ Res, 2020, 126( 11): 1477- 1500. DOI: 10.1161/CIRCRESAHA.120.316101.
[27]	PERDOMO CM, COHEN RV, SUMITHRAN P, et al. Contemporary medical, device, and surgical therapies for obesity in adults[J]. Lancet, 2023, 401( 10382): 1116- 1130. DOI: 10.1016/S0140-6736(22)02403-5.
[28]	MATOS-AZEVEDO AM, DÍAZ-GUËMES MARTÍN-PORTUGUÉS I, PÉREZ-DUARTE FJ, et al. Comparison of single access devices during cut and suturing tasks on simulator[J]. J Surg Res, 2014, 192( 2): 356- 367. DOI: 10.1016/j.jss.2014.06.017.
[29]	WU SD, LV C Jr, TIAN Y, et al. Transumbilical single-incision laparoscopic cholecystectomy: Long-term review from a single center[J]. Surg Endosc, 2016, 30( 8): 3375- 3385. DOI: 10.1007/s00464-015-4618-7.
[30]	TSAI AY, SELZER DJ. Single-port laparoscopic surgery[J]. Adv Surg, 2010, 44: 1- 27. DOI: 10.1016/j.yasu.2010.05.017.
[31]	ZHAO L, WANG ZF, XU J, et al. A randomized controlled trial comparing single-incision laparoscopic cholecystectomy using a novel instrument to that using a common instrument[J]. Int J Surg, 2016, 32: 174- 178. DOI: 10.1016/j.ijsu.2016.06.045.
[32]	YIN HL, WANG ZF, XU J, et al. A specific instrument to facilitate single-incision laparoscopic cholecystectomy: An initial experience[J]. Surg Innov, 2011, 18( 3): 289- 293. DOI: 10.1177/1553350611401428.
[33]	HAN JY, WU SD, TIAN Y. Totally transumbilical single-port laparoscopic cholecystectomy: A report of 10 cases[J]. Chin J Pract Surg, 2010, 30( 7): 587- 589. 韩金岩, 吴硕东, 田雨. 完全经脐单孔腹腔镜胆囊切除术10例报告[J]. 中国实用外科杂志, 2010, 30( 7): 587- 589.
[34]	HAN JY, WU SD, TIAN Y. Clinical analysis of totally transumbilical single-port laparoscopic cholecystectomy in 30 patients[J/CD]. Chin J Laparosc Surg Electron Ed, 2009, 2( 1): 16- 19. DOI: 10.3969/j.issn.1674-6899.2009.01.005. 韩金岩, 吴硕东, 田雨. 完全经脐单孔腹腔镜胆囊切除术30例临床应用分析[J/CD]. 中华腔镜外科杂志(电子版), 2009, 2( 1): 16- 19. DOI: 10.3969/j.issn.1674-6899.2009.01.005.
[35]	ZHANG GY, HU SY, LI F. The application of transumbilical single port laparoscopic cholecystectomy[J]. J Laparosc Surg, 2009, 14( 1): 18- 20. 张光永, 胡三元, 李峰. 经脐单孔腹腔镜胆囊切除术[J]. 腹腔镜外科杂志, 2009, 14( 1): 18- 20.
[36]	CHEN Y, LIN L, FU QH, et al. Comparative study between single-incision laparoscopic cholecystectomy and conventional laparoscopic cholecystectomy[J]. Chin J Bases Clin Gen Surg, 2014, 21( 2): 217- 219. DOI: 10.7507/1007-9424.20140050. 陈英, 林琳, 付庆辉, 等. 单孔腹腔镜与传统腹腔镜胆囊切除的比较研究[J]. 中国普外基础与临床杂志, 2014, 21( 2): 217- 219. DOI: 10.7507/1007-9424.20140050.
[37]	YU F, TIAN ZQ, BAI Y, et al. Clinical risk factors for early complications of laparoscopic cholecystectomy[J]. Chin J Gen Surg, 2015, 24( 8): 1130- 1134. DOI: 10.3978/j.issn.1005-6947.2015.08.015. 余锋, 田志强, 柏杨, 等. 腹腔镜胆囊切除术早期并发症的临床风险因素分析[J]. 中国普通外科杂志, 2015, 24( 8): 1130- 1134. DOI: 10.3978/j.issn.1005-6947.2015.08.015.
[38]	OU X, LIU JK, YIN YX, et al. The application value of laparoscope in delayed bile leakage caused by accessory hepatic duct injury after laparoscopic cholecystectomy[J]. J Laparosc Surg, 2012, 17( 11): 837- 842. DOI: 10.3969/j.issn.1009-6612.2012.11.015. 欧希, 刘吉奎, 尹耀新, 等. 腹腔镜胆囊切除术中损伤副肝管导致迟发性胆漏的腹腔镜治疗价值[J]. 腹腔镜外科杂志, 2012, 17( 11): 837- 842. DOI: 10.3969/j.issn.1009-6612.2012.11.015.
[39]	CHAMBERLAIN RS, SAKPAL SV. A comprehensive review of single-incision laparoscopic surgery(SILS) and natural orifice transluminal endoscopic surgery(NOTES) techniques for cholecystectomy[J]. J Gastrointest Surg, 2009, 13( 9): 1733- 1740. DOI: 10.1007/s11605-009-0902-y.
[40]	YAO C, ZHU LD, WANG LY, et al. Predictive value of nomogram model for incision infection after transumbilical single hole laparoscopic cholecystectomy and analysis of prevention and treatment strategies[J]. Prog Mod Biomed, 2022, 22( 7): 1319- 1323. DOI: 10.13241/j.cnki.pmb.2022.07.026. 姚春, 朱丽丹, 王凌云, 等. 经脐单孔腹腔镜胆囊切除术后切口感染的列线图模型预测价值研究及防治策略分析[J]. 现代生物医学进展, 2022, 22( 7): 1319- 1323. DOI: 10.13241/j.cnki.pmb.2022.07.026.
[41]	HAUETER R, SCHÜTZ T, RAPTIS DA, et al. Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis[J]. Br J Surg, 2017, 104( 9): 1141- 1159. DOI: 10.1002/bjs.10574.
[42]	MA J, CASSERA MA, SPAUN GO, et al. Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy[J]. Ann Surg, 2011, 254( 1): 22- 27. DOI: 10.1097/SLA.0b013e3182192f89.
[43]	MERCHANT AM, COOK MW, WHITE BC, et al. Transumbilical Gelport access technique for performing single incision laparoscopic surgery(SILS)[J]. J Gastrointest Surg, 2009, 13( 1): 159- 162. DOI: 10.1007/s11605-008-0737-y.
[44]	PRYOR AD, TUSHAR JR, DIBERNARDO LR. Single-port cholecystectomy with the TransEnterix SPIDER: Simple and safe[J]. Surg Endosc, 2010, 24( 4): 917- 923. DOI: 10.1007/s00464-009-0695-9.
[45]	Section of Biliary Surgery, Branch of Surgery, Chinese Medical Association, Chinese Committee of Biliary Surgeons. Expert consensus on diagnosis and treatment of common complications after cholecystectomy(2018 edition)[J]. Clin Education General Pract, 2018, 16( 3): 244- 246. DOI: 10.13558/j.cnki.issn1672-3686.2018.03.002. 中华医学会外科学分会胆道外科学组, 中国医师协会外科医师分会胆道外科医师委员会. 胆囊切除术后常见并发症的诊断与治疗专家共识(2018版)[J]. 全科医学临床与教育, 2018, 16( 3): 244- 246. DOI: 10.13558/j.cnki.issn1672-3686.2018.03.002.
[46]	CAO R, WANG GY, LI KW, et al. Clinical analysis of 317 cases of single-port laparoscopic cholecystectomy in a single center during the day[J]. J Hepatopancreatobiliary Surg, 2021, 33( 12): 750- 754. DOI: 10.11952/j.issn.1007-1954.2021.12.010. 曹嵘, 王贵阳, 李可为, 等. 单中心317例日间单孔腹腔镜胆囊切除术临床疗效分析[J]. 肝胆胰外科杂志, 2021, 33( 12): 750- 754. DOI: 10.11952/j.issn.1007-1954.2021.12.010.
[47]	Minimally Invasive Surgery Committee of the Chinese Research Hospital Association. Expert consensus on day-case laparoscopic cholecystectomy[J]. J Laparosc Surg, 2023, 28( 8): 561- 567, 573. DOI: 10.13499/j.cnki.fqjwkzz.2023.08.561. 中国研究型医院学会微创外科学专业委员会. 日间腹腔镜胆囊切除术专家共识[J]. 腹腔镜外科杂志, 2023, 28( 8): 561- 567, 573. DOI: 10.13499/j.cnki.fqjwkzz.2023.08.561.
[48]	TRUJILLO LOLI Y, RODRÍGUEZ-LUNA MR, NORIEGA-USI VM, et al. Single-port laparoscopic cholecystectomy assisted with neodymium magnets: Initial prospective experience with 60 cases[J]. J Laparoendosc Adv Surg Tech A, 2020, 30( 5): 525- 530. DOI: 10.1089/lap.2019.0762.
[49]	TAY CW, SHEN L, HARTMAN M, et al. SILC for SILC: Single institution learning curve for single-incision laparoscopic cholecystectomy[J]. Minim Invasive Surg, 2013, 2013: 381628. DOI: 10.1155/2013/381628.
[50]	FEINBERG EJ, AGABA E, FEINBERG ML, et al. Single-incision laparoscopic cholecystectomy learning curve experience seen in a single institution[J]. Surg Laparosc Endosc Percutan Tech, 2012, 22( 2): 114- 117. DOI: 10.1097/SLE.0b013e31824799ef.
[51]	PAN MX, LIANG ZW, CHENG Y, et al. Learning curve of transumbilical suture-suspension single-incision laparoscopic cholecystectomy[J]. World J Gastroenterol, 2013, 19( 29): 4786- 4790. DOI: 10.3748/wjg.v19.i29.4786.
[52]	LI X, HOU CS, BAI Y, et al. Learning curve for single-incision laparoscopic cholecystectomy by using cumulative summation[J]. Chin J Minim Invasive Surg, 2016, 16( 3): 241- 244. DOI: 10.3969/j.issn.1009-6604.2016.03.013. 李欣, 侯纯升, 白洋, 等. 单孔腹腔镜胆囊切除术的学习曲线: 累积求和分析法[J]. 中国微创外科杂志, 2016, 16( 3): 241- 244. DOI: 10.3969/j.issn.1009-6604.2016.03.013.