LC术后近期腹痛的原因分析及处理

Analysis of the causes and treatment of abdominal pain in the early postoperative period after laparoscopic cholecystectomy

目的 总结腹腔镜胆囊切除术 (LC )后近期腹痛的原因 ,以便采取预防措施。方法 回顾性分析 3 5例LC后近期腹痛患者的临床资料并复习文献。再手术治疗 9例 ,非手术治疗 2 6例。结果 损伤性因素 8例 ,其中术后胆漏 6例 ,腹壁戳孔结石残留 2例 ;非损伤性因素 2 7例 ,包括胆道蛔虫症 2例 ,胆总管结石 5例 ,急性胰腺炎 1例 ,胆道功能紊乱 17例 ,十二指肠球部溃疡 1例 ,胃癌 1例。 3 5例均治愈。结论 完善LC术前检查 。

Objective To summarize the causes of abdominal pain in the early postoperative period after laparoscopic cholecystectomy(LC), so as to employ preventative measures. Methods The clinical data of 35 patients with early postoperative abdomial pain after LC were analyzed retrospectively and the literature was reviewed . Nine cases underwent reoperation, and conservative treatment was successfully performed in the other 26 cases. Results Traumatic factors were involved in 8 cases, including 6 cases of postoperative biliary fistula , and 2 cases with calculus retained in the trocar hole of the abdominal wall. 27 cases had no traumatic factor and included 2 cases of ascariasis of common bile duct, 5 cases with calculus of common bile duct, 1 case of acute pancreatitis, 17 cases of bile duct dysfunction, 1 case of duodenal ulcer and 1 case of stomach cancer. All were cured. Conclusions The key to decrease complications after LC is a complete examination before LC and pay attention to each aspect of perioperative management.