腹腔镜胆囊切除术结石漏入腹腔的原因及对策

The cause and strategy of falling into the abdominal cavity of calculus during the laparoscopic cholecystectomy

目的：探讨腹腔镜胆囊切除术结石漏入腹腔的原因及防治对策。方法：回顾性分析我院1998年至2007年1200例腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）结石漏入腹腔的临床资料。结果：1200例LC共发生结石漏入腹腔61例,随访1-8年,无腹腔脓肿、窦道形成等并发症发生。结论：LC术中胆囊分破、取出时撕破、血管钳扩开戳孔时刺破胆囊是结石漏入腹腔的主要原因,术中避免以上情况的发生并将漏入腹腔结石取净是避免术后并发症发生的关键。

Objective：To explore the cause and strategy of falling into the abdominal cavity of calculus during the laparoscopic cholecystectomy （LC）. Methods ： The clinical data of 1 200 cases of LC with calculus falling into the adbominal cavity were analyzed respectively from 1998 to 2007. Results：The falling into abdominal cavity of calculus happened in 61 of 1 200 cases. There are no complications of peritoneal abscess and sinus during the foUowing up of 1 to 8 years. Conclusions：The rupture of gallbladder when dissecting it from the liver and taking it out from the abdominal cavity is the main cause of falling into the abdominal cavity of calculus. To avoid the rupture of gallbladder and remove all the calculus falling into abdominal cavity are the key of avoiding complications postoperatively.