腹腔镜胆囊摘除术及其并发症的防治

Prevention and cure of the complication of laparoscopiccholecystectomy

目的探讨腹腔镜胆囊切除术（1aparoscopiccholecystectomy，LC）并发症的预防及治疗。方法总结分析我院2005年6月至2008年12月间住院治疗的1255例LC患者出现5例并发症的临床资料，提出防治措施。结果1255例LC手术成功，发生并发症5例，其中胆瘘1例，皮下血肿1例，切口愈合不良1例，胆囊动脉后支撕脱出血转开腹止血术2例。全部治愈。结论严格掌握LC适应证，熟悉局部解剖和变异，术中操作轻柔、规范手术程序、明确胆囊三角结构，是预防手术并发症的关键，必要时果断中转手术，腹腔引流是预防和减少并发症的有效措施。

Objective To investigate the prevention and cure of the complication of laparoscopicchole-cystectomy （LC）. Methods Collect and summarize the clinical data of 5 cases of LC patients with complications out of 1255 cases between June 2005 and December 2008. Then come up the prevention and cure measures. Results 5 out of 1255 LC patients have complications, of which 1 case is biliary fistula, 1 case is ecchymoma, lcase has wound dys-healing, 2 cases have arteria cystica posterior branch bleeding. Conclusions The indication of LC should be controlled strictly, topography and variation should be mastered, the light and soft performance and the standard operative procedure are the key to prevent the occurrence of complication.