腹腔镜胆囊切除术并发症分析

Serious Complications in Laparoscopic Cholecystectomy: with an Analysis of 10 Cases

目的:对腹腔镜胆囊切除术发生严重并发症的常见原因进行分析。方法:回顾总结986例腹腔镜胆囊切除术中出现的10例严重并发症,其中因钛夹松脱致胆汁漏2例、膈下脓肿1例、胆总管损伤3例、胆总管残余结石2例、十二指肠损伤1例、气腹针穿刺致空肠穿孔1例。结果:10例严重并发症均查出原因,经治疗未出现严重后果。结论:导致腹腔镜胆囊切除并发症的原因为局部粘连、炎性水肿严重;脐孔周围严重的腹腔粘连;术者经验欠丰富,操作欠熟练。

Objective To analyze the causes of serious complication occurred in laparoscopic cholecystectomy.Methods 10 cases with serious complications out of 986 cases that were performed laparoscopic cholecystectomy(LC) were retrospectively analyzed. The operative complications included bile leakage caused by titanic clip exfoliation in 2 cases, subphrenic abscess in 1 case, bile duct injury in 3 cases, remnant choledoch stone in 2 cases, duodenum injury in 1 case, jejunum perforation caused by pneumascos needle centesis in 1 case.Result The patients have all been found causes and cured successfully.Conclusion The causes of complication in laparoscopic cholecystectomy were local adhesion, serious inflammatory edema; serious intraperitoneal adhesion around navel; poor experience and less practice of the surgeons.