Evolution of Laparoscopic Cholecystectomy: From Multiport to Single Port

O. Karakuş, Oktay Ulusoy
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Abstract

Context: Laparoscopic approach with its several techniques has become the standard method for cholecystectomy over the past decades. As technical instruments have improved and varied, the interest in endoscopic surgery has turned towards minimal invasive single site access surgery with fewer instruments, thus resulting in minimal pain, minimal scarring and better cosmesis. Evidence Acquisition: A systematic literature searching of databases MEDLINE, EMBASE, and Google Scholar was done from 1982 and updated in December 2015. Search terms were “cholecystectomy”, “laparoscopic cholecystectomy”, “four port laparoscopic cholecystectomy”, “single-incision laparoscopic surgery”. Results: Four-port laparoscopic cholecystectomy was accepted as the “gold standard” in the treatment of patients with cholelithiasis before millennium. Thereafter, two-port laparoscopic cholecystectomy was reported as a novel, safe and rapid method of gallbladder removal in consecutive reports. Single-site laparoscopic cholecystectomy with non-conventional multi-channel port method was first introduced as an alternative to the standard multi-port laparoscopic cholecystectomy in adult patients in the last decade. Success rates of performing conventional four-port laparoscopic cholecystectomy were ranging from 93% to 100% and single site laparoscopic cholecystectomy was ranging from 84% to 100%. Conclusions: Currently, it has been widely accepted that laparoscopic cholecystectomy is the gold standard for cholecystectomy. Although single site laparoscopic cholecystectomy is becoming more popular with the recent advancements, conventional multiport laparoscopic cholecystectomy is being widely used as the primary treatment modality for the gallbladder removal.
腹腔镜胆囊切除术的发展:从多腔到单腔
背景:在过去的几十年里,腹腔镜入路及其几种技术已成为胆囊切除术的标准方法。随着技术器械的改进和多样化,对内窥镜手术的兴趣已经转向微创单部位手术,使用更少的器械,从而产生最小的疼痛,最小的疤痕和更好的美容。证据获取:从1982年开始对MEDLINE、EMBASE和谷歌Scholar数据库进行系统文献检索,并于2015年12月更新。检索词为“胆囊切除术”、“腹腔镜胆囊切除术”、“四口腹腔镜胆囊切除术”、“单切口腹腔镜手术”。结果:千年前,四孔腹腔镜胆囊切除术被公认为治疗胆石症的“金标准”。此后,连续报道双孔腹腔镜胆囊切除术作为一种新颖、安全、快速的胆囊切除方法。近十年来,非传统多通道通道单部位腹腔镜胆囊切除术首次作为标准多通道腹腔镜胆囊切除术的替代方案被引入成人患者。常规四孔腹腔镜胆囊切除术的成功率为93% ~ 100%,单孔腹腔镜胆囊切除术的成功率为84% ~ 100%。结论:目前,腹腔镜胆囊切除术已被广泛认为是胆囊切除术的金标准。尽管近年来单部位腹腔镜胆囊切除术越来越受欢迎,但传统的多孔腹腔镜胆囊切除术仍是胆囊切除术的主要治疗方式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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