腹腔镜胆囊切除术13000例的并发症分析  

Complications of laparoscopic cholecystectomy: analysis of 13 000 cases in a single center

作　　者：王宏光[1] 陈训如[1] 罗丁[1] 毛静熙[1] 周正东[1] 余少明[1] 李胜宏[1] 

机构地区：[1]成都军区昆明总医院肝胆外科,昆明650032

出　　处：《中华普通外科杂志》2006年第3期167-168,共2页Chinese Journal of General Surgery

摘　　要：目的探讨腹腔镜胆囊切除术(LC)的并发症及预防、处理措施。方法对13 000例 LC的并发症进行回顾性分析。结果共发生并发症216例(1．66%),其中腹腔内出血21例 (0．16％),胆管损伤11例(0．08%),胃肠道损伤7例(0．05％),胆漏26例(0．20%),遗漏腹腔内肿瘤病变10例(0．08%),胆管残留结石47例(0．36％),腹腔感染4例(0．03％),上消化道出血2例 (0．02％),皮下气肿32例(0．25%),切口感染46例(0．35％),戳孔疝1例(0．01％),下肢深静脉血栓形成9例(0．07％)。死亡6例(0．05％),本组无LC技术性并发症导致死亡病例。结论规范 LC操作技术,遵循操作原则对于保障LC手术的安全,预防和减少并发症仍然有现实意义。Objective To probe the prevention and management of complications after laparoscopic cholecystectomy （ LC ）. Methods Retrospective study was performed on 13 000 patients, who underwent LCs from September 1991 to February 2005 at our department. Results The complication rate was 1.66% （216 patients） including intraabdominal hemorrhage in 21 patients （0. 16% ）, bile duct injury in 11 （0. 08% ）, gastrointestinal perforation in 7（0. 05% ）, bile leakage in 26（0. 20% ）, retained abdominal tumor in 10（0. 08% ）, retained common bile duct stones in 47（0. 36% ）, intraabdominal abscess in 4（0. 03% ）, upper gastrointestinal hemorrhage in 2（0. 02% ）, extensive subcutaneous emphysema in 32 （0. 25% ）, port wound infection in 46（0. 35% ）, incisional hernia in 1 （0. 01% ） and deep vein thrombosis in 9（0. 07% ）. Six patients died postoperatively. Conclusions LC is a safe technique when up-to-date equipment and meticulous dissection techniques are employed. With the routine procedure, LC can be performed more safely.

关 键 词：胆囊切除术 腹腔镜 手术中并发症 

分 类 号：R657.4[医药卫生—外科学] R651[医药卫生—临床医学]