关键词: 经脐单孔；三孔；腹腔镜；胆囊切除术；胆囊炎

Abstract: Objective To explore the comparison of the clinical efficacy of laparoscopic cholecystectomy based on propensity score matching through the umbilical single hole method and three holes method in the treatment of acute cholecystitis.Methods 106 patients with acute cholecystitis who underwent laparoscopic cholecystectomy in our hospital from January 2020 to December 2022 were selected as research subjects.According to different treatment methods,they were divided into the study group (n=64) and the control group (n=42).The patients in the study group were treated with single port via umbilical laparoscopic cholecystectomy,while the control group was treated with three port laparoscopic cholecystectomy.Compare the surgical related indicators,postoperative recovery,and postoperative complications between the two groups of patients.Results Comparing the general information of the two groups of patients,there was no significant difference in body mass index (BMI),BMI,and gallbladder ultrasound results (P>0.05),but the average age of the study group patients was greater than that of the control group patients (P<0.05).By comparing the general data of the two groups of patients after propensity score matching,it was found that there was no significant difference in gender,age,BMI,and gallbladder ultrasonography results between the two groups (P>0.05).The surgical time for the study group patients was (61.48±10.24) minutes,while for the control group,it was (40.42±8.35) minutes;And the visual analog scale (VAS) scores at 6 and 24 hours after surgery were (5.63±1.04) and (3.42±0.65) for the study group,respectively,while (7.22±1.61) and (5.48±1.02) for the control group.The pain sensation was more pronounced (P<0.05);However,there was no statistically significant difference in blood loss during surgery between the two groups of patients (P>0.05).The hospitalization time and gastrointestinal function recovery time of the study group patients were (2.05±0.42) days and (33.46±4.30) hours,respectively,while the control group was (3.95±1.02) days and (47.58±7.62) hours,respectively;And the satisfaction score of the study group patients with incision scars was (4.58±0.42) points,while the control group was (3.02±0.38) points (P<0.05).The total incidence of complications in the study group was 2.78%,while in the control group it was 16.67%,significantly lower in the study group (P<0.05).Conclusion Patients with acute cholecystitis treated with the umbilical single hole method have significantly lower postoperative pain,shorter hospital stay,and recovery time of gastrointestinal function compared to the three hole method.Patients also have higher scores of satisfaction with incision scars,and the overall incidence of postoperative complications is also lower.

Key words: transumbilical single hole method；three hole method；laparoscope；cholecystectomy；cholecystitis