腹腔镜胆囊切除术及其并发症的预防（附30例报告）

PREVENTION OF COMPLICATIONS IN LAPAROSCOPIC CHOLECYSTECTOMY

用腹腔镜行胆囊切除术（ＬＣ）３０例。术前均经Ｂ超检查（其中２３例加做了静脉胆道造影）确诊为胆囊结石者２４例和胆囊息肉６例。３０例中有２９例获手术成功（９６．７％），１例因胆囊萎缩在术中转为开腹术；出现并发症者４例，其中１例因胆囊床出血转为开腹后发现出血已停，另３例术后出现皮下气肿。手术时间最短１５ｍｉｎ，最长８７ｍｉｎ，平均２８ｍｉｎ。住院时间最短４天，最长１１天，平均６．５天。对并发症的预防，作者强调严格选择手术适应证、作好术前准备及正确的技术操作是预防和减少并发症的关键。

From August through December 1994,30 patients(12 males and 18 females) including 24 with gallstones, and 6 with polypus,preopratively diagnosed by ultrasonography or/and intravenous cholangiography, underwent laparoscopic cholecystectomy(LC).It was successfully performed in 29(96.7%), in one of 30 cases open surgery was needed due to cicatricial gallbladder. One patient was complicated with gallbladder bed hemorrhage, which spontaneously stopped just as her abdomen was surgically opened. Three patients were complicated with subcutaneous emphysema during and after LC. The procedure took 15 to 87 minutes with an average of 28 minutes. The mean hospitalization period was 6.5 days(range from 4 to 11 days).It might be of significance that the patients should be preperly selected,the operative preparations adequately made, and the procedure meticulously performed in order to reduce LC complications.