1021例腹腔镜胆囊切除术中术后并发症的原因分析

Causes Analysis of Complications after Laparoscopic cholecystectomy in 1021 Cases

目的:探讨腹腔镜胆囊切除术并发症的原因。方法:回顾性分析某医院自1997年7月～2011年7月腹腔镜胆囊切除所出现的并发症的临床资料。结果:术中发现的急性期及解剖异常79例,术后2例出血,1例胆漏,胆囊管内结石残留1例,胆总管误扎1例,1例胆总管损伤,2例肝功能不正常。术后随访均恢复良好。结论:腹腔镜下切除胆囊是安全、有效的手术方式,具有恢复快、出血少等优点;急性发作期>72h者不宜行急诊腔镜手术,米里齐综合征患者不宜行腹腔镜手术,解剖异常者手术要注意解剖层次。

Objectives ：To discuss common cause of complication after peritoneal cavity mirror gallbladder resec- tion.Methods ：retrospective analysis of the clinical data from July 1997 to July 2011 in my hospital.Results：During surgery,79 cases were found in acute phase and abnormal anatomically. After surgery, 2 cases bleed, 1 case bile leak- age,1 case cystic duct chololith during laparoscoplic cholecystectomy, 1 case Common bile duct ligation, 1 case Bile duct injury,2 cases abnormal liver function. All recover well in follow-up visits after surgery.Conclusion：Laparoscopic cholecystectomy is safe and effective with quick recovery and no hemorrhage. Surgery is not a [ppropriate if acute episode〉72h.Mirizzi syndrome patients are not suitable to undergo laparoscopic surgery. Anatomical level should be paid attention to for those prove abnormal anatomically.