腹腔镜胆囊切除术常见并发症及其防治

Complications of laparoscopic cholecysteetomy and its prevention and treatment

目的分析腹腔镜胆囊切除术常见并发症发生的原因,探讨其防治措施。方法选择2006年1月至2013年6月382例腹腔镜胆囊切除术患者,对出现并发症的15例患者进行回顾性分析。结果 15例出现并发症的患者中胆管损伤5例(33.3%),胆漏3例(20.0%),术中出血3例(20.0%),胃肠道损伤2例(13.3%),胆管残石1例(6.7%),术后下肢深静脉血栓1例(6.7%)。结论严格掌握手术适应证,做好术前准备,熟悉胆囊三角的解剖结构,了解腹腔镜胆囊切除术常见并发症的原因,必要的中转开腹是减少各种并发症的重要手段。

Objective To analyze the causes of complications in laparoscopie cholecystectomy （LC） and ex- plore the prevention and treatment of these complications. Methods In 382 patients underwent LC from January 2006 to June 2013, 15 cases had complications, whose data were retrospectively analyzed. Results Among these cas- es, there were 5 eases with bile duet injury （33.3%）, 3 cases with bile leakage （20.0%）, 3 cases with bleeding （20.0%）, 2 cases with digestive duct injury （13.3%）, I eases with remnant common bile duct calculi （6.7%）, and 1 eases with deep venous thrombosis after operation （6.7%）. Conclusion Operation must be performed with strict indications. It is criti- cal to do the preparation well before operation. Surgeons must be familiar with regional anatomy and the cause of com- plications in LC. Besides, timely conversion to open cholecysteetomy is an important way to reduce complications in LC.