腹腔镜胆囊切除术后出血的预防和处理

Prevention and management of hemorrhage after laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术(Laparoscopic cholecystectomy,LC)术后出血的预防和处理.方法回顾分析1991～2003年15例LC术后出血病例.结果该组15例患者LC术后出现不同程度的出血,出血量50～1200ml.其中6例腹腔内出血,9例腹壁穿刺孔出血.6例腹腔内出血病例中,4例行剖腹探察止血,2例保守治疗.9例腹壁穿刺孔出血病例中,5例行局部压迫后止血,3例行切口缝合止血.结论LC术中确切止血是防止术后出血的关键.

Objective: To study the prevention and management of the hemorrhage after laparoscopic cholecystectomy (LC). Methods: The medical data on 15 cases with hemorrhage after LC from 1991 to 2003 were analyzed retrospectively. Results: Fifteen cases had hemorrhage after LC to various degrees. The loss of blood range form 50~1 200 ml. Six of the 15 cases had intraperitoneal hemorrhage while 9 of them had hemorrhage in the wound in the abdominal wall. Four of the 6 cases mentioned above were cured by abdominal exploring operation, the other 2 of the 6 were cured by a conservation therapy. Five of the 9 cases with wound hemorrhage were cured by pressing the place of bleeding, and the rest were treated by suture. Conclusions: A reliable hemostasis is the guarantee of the prevention of hemorrhage after LC.