Effect of Modified Transumbilical Single-incision Laparoscopic Cholecys-tectomy on Stress Response and Postoperative Recovery in Middle-aged and Elderly Patients with Calculous Cholecystitis Complicated with Coronary Heart Disease
CHEN Jian
HE Qiang
ZHANG Le
YANG Xuegan
WU Xiaoyun
SU Haiyan
ZHU Hongjiang
Abstract：Objective To analyze the effect of modified transumbilical single-incision laparoscopic cholecystectomy on stress response and postoperative recovery of middle-aged and elderly patients with calculous cholecystitis complicated with coronary heart disease(CHD).Methods In total,150 middle-aged and elderly patients with calculous cholecystitis compli-cated with CHD admitted from July 2021 to December 2022 were retrospectively selected for study,and were divided into tra-ditional three-incision group(n=78)and modified single-incision group(n=72)according to different surgical protocols.The traditional three-incision group received conventional laparoscopic cholecystectomy,and the modified single-incision group received modified transumbilical single-incision laparoscopic cholecystectomy.The perioperative and postoperative recovery,inflammation indexes,stress indicators,myocardial enzyme levels before and at 12 h after surgery,and complications during postoperative hospitalization were compared between the two groups.Results Compared with the traditional three-incision group,the modified single-incision group had longer duration of surgery,less intraoperative blood loss,shorter time to first food intake,the first time of anal exhaust and length of hospital stay(P<0.05).At 12 h after surgery,serum levels of inter-leukin-6,tumor necrosis factor-α,C-reactive protein,norepinephrine,cortisol,epinephrine,myocardial creatine kinase isoenzyme and cardiac troponin I in the two groups were higher than those before surgery,but lower in the modified single-incision group(P<0.05).During postoperative hospitalization,the total complication rate of the traditional three-incision group was 11.54％(9/78),which was higher than that of the modified single-incision group 2.78％(2/72,P<0.05).Conclusion Modified transumbilical single-incision laparoscopic cholecystectomy can reduce stress response,inhibit inflam-mation,relieve myocardial damage,promote postoperative recovery and improve safety in middle-aged and elderly patients with calculous cholecystitis complicated with CHD.
Keywords：Calculous cholecystitisCoronary heart diseaseMiddle-aged and elderlyModified transumbilical sin-gle-incision laparoscopic cholecystectomyStress responseRecovery after surgeryMyocardial enzymesInflammation
Publication Date：2025-01-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 60-64 )