腹腔镜手术严重并发症的有效预防(附1157例分析)

Effective prevention of severe complications during laparoscopic operations

目的:总结腹腔镜手术1157例有效预防严重并发症的成功经验。方法:回顾分析本组腹腔镜手术1157例的临床资料,其中腹腔镜胆囊切除术(LC)1145例,附带阑尾切除10例、卵巢囊肿切除5例、腹腔黏连松解术13例。腹腔镜肝囊肿开窗引流术10例,肾囊肿去顶术和精索静脉曲张结扎术各1例。结果:成功实施腹腔镜手术1142例,中转手术15例,手术中转率为2%,1157例全部治愈。无胆管损伤、腹腔内出血、脏器损伤及腹腔感染等严重并发症。结论:开放式置管建立气腹是避免血管及脏器意外损伤的有效方法,仔细谨慎操作是预防胃肠道损伤的关键,采用钝性、锐性分离相结合法谨慎解剖Calot三角是预防胆管损伤的有效措施,而适时中转手术是预防腹腔镜手术严重并发症的关键。

Objective To summarize the successful experience of 1157cases of laparoscopic operation without severe com-pli cations.Method To analyse retrospectively the following clinical data:1157patients were undergone laparoscopic operation success fully including1145cases of LC,among them10of appendectomy,5of resection of ovary cyst,13of excision of adhe-sive ileus.Additional10of hepatic cyst,1of renal cyst drainage and varicocelectomy.Results1142cases were performed suc-cessful ly,15cases converted to open cholecystectomy.All were cured without biliary tract injury,hemorrhage,viscera injury and ab dominal in fections.Conclusion It is key point for preventing the above complications to perform carefully,careful anatomy of Calot triangle by dull and sharp dissection,and timely convert to open.