腹腔镜胆总管探查并发症分析

Complications of Laparoscopic Exploration of the Common Bile Duct

目的探讨腹腔镜胆总管探查并发症的处理和预防。方法回顾性分析我科2003年6月~2007年6月124例腹腔镜胆总管探查出现的13例并发症资料。结果术中发现胆总管穿孔性损伤3例(其中胆道合并十二指肠穿孔1例),术中出血2例;术后发现十二指肠穿孔1例,胆漏2例(一期缝合),术后腹腔出血1例,胆道残石4例。全部治愈。胆道穿孔3例开腹修补后随访6个月无胆管狭窄,4例胆道残石取石后随访1~4年,未见结石复发。结论必须严格腹腔镜胆总管探查指征和强化术者的操作技巧和方式。实行适时中转开腹,对并发症进行即时有效的处理,其预后是良好的。

Objective To investigate the complications of laparoscopic exploration of the common bile duct,and its prevention.Methods From June 2003 to June 2007,a total of 124 patients received laparoscopic exploration of the common bile duct in our department,13 of them developed complications.The data of these 13 patient were analyzed retrospectively.Results Among the 13 cases,3 had intraoperative perforation of the common bile duct(one of them was complicated with perforation of the duodenum),2 had intraoperative h...