腹腔镜胆囊切除术并发症的防治

Prevention and treatment of complications of laparoscopic cholecystectomy

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)并发症的预防及治疗手段。方法:总结分析461例LC的临床资料。结果:459例LC手术成功(其中1例术后残余胆总管结石,经内镜十二指肠乳头切开取石治疗痊愈),2例中转开腹。结论:基层医院严格掌握LC适应证,重视并存病和围手术期处理,术中熟悉局部解剖和变异,正确处理好Calot三角,精细操作,是预防手术并发症的关键,必要时果断中转手术。腹腔引流也是预防和减少并发症的有效措施。

Objective ： To discuss the prevention and treatment of complications of laparoseopie eholeeysteetomy （ LC ）. Methods：The clinical data of 461 cases of LC was summarized and analyzed. Results：Four hundred and fifty-nine cases of LC were successful （one case of residual calculi of common bile duct was healed by the treatment of EST） ,2 cases were converted to open surgery. Conclusions：The key of prevention of complications included：strict control of indications of LC, attaching attention to the coexisting diseases and perioperative management, acquaintance of the regional anatomy and variance during the operation, correctly management of triangle Calot,finely manipulation and convertion if necessary. Also the drainage is an effective measurement for prevention and reduction of complications.