摘要目的 评价单孑L腹腔镜胆囊切除术(SILC)的安全性和有效性.方法 收集2010年至2012年公开发表的SILC和传统腹腔镜胆囊切除术(LC)治疗胆囊良性疾病的中文和英文文献,对SILC组和LC组的术后并发症情况、术后恢复情况及术中情况进行荟萃分析.结果 筛选出符合纳入标准的研究11项共859例患者,SILC组449例,LC组410例.与LC组相比,SILC组术后美容效果更好,差异有统计学意义(Ⅳ=0.95,95％CI:0.56 ～ 1.34,Z=4.76,P=0.00),但在手术时间上SILC组明显长于LC组,差异有统计学意义(Ⅳ=16.66,95％CI:9.60 ～ 23.72,Z=4.62,P=0.00)；两组患者术中出血量、术中中转率、术后6 ～24 h疼痛情况、住院时间及术后并发症方面的差异则无统计学意义(P＞0.05).结论 SILC是安全可行的,具有优于LC的美容效果；但手术操作难度较大,手术时间长,有一定经验的医师方能施行.

abstractsObjective To study feasibility and security of single-incision laparoscopic cholecystectomy (SILC).Methods Clinical trials comparing SILC with conventional laparoscopic cholecystectomy (LC) for benign gallbladder disease published from 2010 to 2012 were retrieved.A metaanalysis was conducted to evaluate operative time,blood loss,conversion rate,post-operative pain,wound satisfaction score,post-operative hospital stay and post-operative complications between SILC group and LC group.A fixed effect model or random effect model was established to collect the data.Results Eleven random clinical trials on 859 patients qualified for the meta-analysis,449 patients being allocated to SILC and 410 patients to LC.There was no significant difference between SILC group and LC group for blood loss,conversion rate,post-operative pain,post-operative hospital stay and post-operative complications.However,operative time was significantly longer in SILC group than LC group (Ⅳ =16.66,95％ CI:9.60-23.72,Z =4.62,P =0.00).Furthermore,wound satisfaction score was significantly higher in SILC group than in LC group (Ⅳ=0.95,95％CI:0.56-1.34,Z=4.76,P=0.00).Conclusions SILC may be superior to LC in terms of cosmetic outcome,but not in operative time.Currently,SILC is a safe procedure for proper patients in experienced surgeons.