腹腔镜胆囊切除手术并发症预防措施

THE PREVENTION OF COMPLICATIONS RESULTING FROM LAPAROSCOPIC CHOLECYSTECTOMY:A REPORT OF 2652 CASES

目的探讨腹腔镜胆囊切除术并发症发生的原因。预防、减少并发症,提高手术安全性。方法回顾分析我院 1996年10月至2005年4月2652例LC资料。结果 2652例中胆囊结石1796例,胆囊隆起样变606例,慢性胆囊炎186例,慢性胆囊炎急性发作64例。共发生并发症22例,发生率0．83％。其中胆管损伤1例,胆漏6例,腹腔出血2例,胆囊床积液8例, 皮下气肿3例。均治愈出院。结论为预防和减少并发症,应严格选择病例,掌握LC适应症,熟练LC操作技术,适时中转开腹是降低LC并发症发生的关键,置管引流和术后监护十分必要。

Objective To study the reason of the complications resulting from LC, to decrease the incidence and inprove the safety of LC. Methods The date of 2652 patients performed LC in our hospital between October 1996 and April 2005 was analyzed retrospectively. Result Among all the cases. 1976 cases were diagnosed as cholecystolithiasis and 606 eases were diagnosed as gaIlbladder polyps. There were 186 cases diagnosed as chronic cholecystitis and 64 cases of which were chronic eholecystitis acute episode. The complication rate was 0. 83%, （22 eases）. The complications included entrahepatic bile duets injury （1 cases ）, bile leakage （6 cases ）, bleeding （2 cases ）, fossa of gallbladder amassing liquid （8 cases ）, intraperitoneal infection （2 cases） and subculaneous emphysema（3 cases）. All cases have been cured and discharged. Conclusion In order to prevent and decrease the rate of complications,the choice of patients and the adaptation of LC should be controlled strictly. Surgery should be performed ,which is the key to decrease the rate of complications.