基层医院腹腔镜胆囊切除术并发症分析

Analysis of complications of laparoscopic cholecystectomy in primary hospital

目的探讨基层医院腹腔镜胆囊切除术后并发症发生的原因、预防和处理。方法回顾性分析2003年3月至2011年9月427例行腹腔镜胆囊切除术患者的临床资料。结果 427例患者中,中转开腹胆囊切除术32例(7.49%),出现并发症21例(4.92%),其中术后出血5例;胆管损伤4例;胆漏4例;胆管残留结石3例;胃肠道损伤2例;切口感染3例。经正确诊断及处理,均痊愈出院。结论随着腹腔镜技术的成熟,手术医生经验的积累,基层医院开展腹腔镜胆囊切除术是安全可行的。

Objective To investigate the causes,prevention and managements of complications of laparoscopic cholecystectomy（LC） in primary hospital.Methods The clinical data of 427 patients undewent LC in our hospital from March 2003 to September 2011 were analyzed retrospectively.Results Thirty-two patients（7.49%） were converted to laparotomy,and 21 cases（4.92%） suffered from complications,including postoperative hemorrhage（5 cases）,bile duct injuries（4 cases）,bile leakage（4 cases）,remnant calculus in bile duct（3 cases）,injury of gastrointestinal tract（2 cases） and incision infection（3 cases）.All the complications were cured successfully.Conclusion With proven technique and accumulation of surgical experience,LC is a safe and feasible procedure in primary hospital.