腹腔镜胆囊切除术后胆囊床积液的处理体会  

The postoperative hydrops of gallbladder bed of laparoscopic cholecystectomy

作　　者：苏光源 孙小林[1] 靳巍[1] 

机构地区：[1]中国人民解放军第531医院外一科,134002

出　　处：《吉林医学》2000年第2期84-85,共2页Jilin Medical Journal

摘　　要：目的 :为观察腹腔镜胆囊切除术后胆囊床积液的程度及进行处理。方法 :使用 B超对 30 7例实施腹腔镜胆囊切除术的患者进行观察 ,并对术后出现胆囊床积液的患者进行 B超随访。结果 :胆囊床积液 191例 (占 6 2 .2 % ) ,其中 176例 (176 / 191,92 .1% )未出现任何不适症状 ,术后 2周内 B超复查胆囊床积液消失。 15例 (15 / 191,7.9% )出现临床症状 ,其中 13例患者经抗炎对症治疗痊愈 ;2例患者在 B超引导下行胆囊床区包裹性积液穿刺抽液及抗炎对症治疗后痊愈。结论 :腹腔镜胆囊切除术后早期多数患者 B超检查可能会发现胆囊床积液 ,对于无症状的胆囊床积液患者 ,不需特殊处理 ,积液可自行消失 ;对于出现临床症状的胆囊床积液患者 ,经抗炎对症治疗后 ,多数患者亦可痊愈 ,少数患者需及时在 B超引导下行胆囊床区积液穿刺抽液治疗。Objective To disscus the clinical observation and treatment of the postoperative hydrops of gallbladder bed of laparoscopic cholecystectomy.Method Using B-type ultrasonography,307 patients of laparoscopic cholecystectomy were observed,and those who suffered from postoperative hydrops of gallbladder bed were followed-up surveyed.Results 191 patients(191/307,62 2%)with hydrops of gallbladder bed,176 patients(176/191,92 1%)with no clinical symptoms among them,the hydrops of gallbladder bed was disappeared within 2 weeks after the operation by B-type ultrasonic reexamination.15 patients(15/191,7.9%)had clinical symptoms,of the 13 patients were recovered by anti-infectious treatment,of 2 patients were recovered by B-type ultrasonic guided percutaneous puncture and aspiration to treat the encapsulated hydrops of gallbladder bed and anti-infectious treatment.Couclusion In the early stage after laparoscopic cholecystectomy,most patients can be examined the hydrops of gallbladder bed by B-type ultrasonic examination,for the patients of the hydrops of gallbladder bed with no symptoms,they need not special treatment,but the hydrops could be absorbed and disappeared;For the patients of the hydrops of gallbladder bed with clinical symptoms,most patients will be cured by anti-infectious treatment,minority patients should be treated by B-type ultrasonic guided percutaneous puncture and aspiration to treat the encapsulated hydrops of gallbladder bed in time.

关 键 词：腹腔镜 胆囊切除术 胆囊床 积液 治疗 

分 类 号：R657.4[医药卫生—外科学]