高难度腹腔镜胆囊切除术并发症的原因分析及对策  

Analysis on complications of extremely difficult laparoscopic cholecystectomy

作　　者：种锦贵[1] 黄河[1] 毛岸荣[1] 蒋晓[1] 胡剑平[1] 崔小红[1] 王振乾[1] 辛海贝[1] 丁科[1] 

机构地区：[1]解放军第85医院普外科,上海200052

出　　处：《临床军医杂志》2014年第4期351-354,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨高难度腹腔镜胆囊切除术(LC)并发症的原因及处理对策。方法对2004年1月—2008年12月我科实施的615例LC患者的临床资料进行回顾性分析。结果 615例中共发生并发症15例(2.44%),其中胆管损伤4例(0.65%),胆漏2例(0.33%),出血2例(0.33%),残余结石3例(0.49%),切口肿瘤种植2例(0.33%),腹痛1例(0.16%)。结论充分的围术期准备,手术恰当的时机选择,熟练的腹腔镜操作技能,掌握并发症的发生原因及相应对策,是提高手术成功率与降低手术并发症的关键。Objective To analyze the causes of the complications of difficult laparoscopic cholecystectomy （LC） and their counter- measures. Methods The clinical data of 615 patients who had undergone LC during Jan. 2004 and Dec. 2008 were analyzed ret- rospectively. Results Of the 615 patients, 15 （2.44%） suffered from serious complications including bile duct damage in 4 （0.65%） cases, biliary fistula in 2 （0.33%） cases, intraperitoneal hemorrhage in 2 （0.33%） cases, residual calculi in 3 （0.49%） ca- ses, port site metastasis in 2 （0.33%） cases, abdominal pain in 1 （0.16%） case. Conclusion Sufficient perioperative manage- ment, good operation chance, right operation method and skilled laparoscopic skills, as well as preventative measures against com- plications, are the keys to the success in LC and to the reduction in complications.

关 键 词：胆囊切除术 腹腔镜 并发症 

分 类 号：R657.4[医药卫生—外科学]