腹腔镜胆囊切除术并发症的分析与防治体会

目的研究分析腹腔镜胆囊切除术(LC)并发症的原因,探讨如何减少和预防腹腔镜胆囊切除术并发症的发生。方法回顾性分析2011年1月至2012年1月351例胆囊疾病患者行腹腔镜胆囊切除术的临床资料。结果 351例腹腔镜胆囊切除术,发生胆漏4例,胆道损伤2例,腹腔出血1例,皮下气肿1例,结石残留2例,腹腔脓肿2例,术后呕吐4例,胆绞痛1例,经采取正确的治疗方法和护理策略,患者均治愈出院。结论严格掌握手术适应证,熟练掌握手术技术,术中仔细操作,特别要注意Calot三角解剖变异,适时中转开腹,术后严密观察病情变化,加强术后护理,及时发现术后并发症并正确处理。

Analysis and Prevention of the Complications of Laparoscopic Cholecystectomy

Objective To analyze the reason of complications in cholecystectomy（LC）, and to explore ways of reducing and preventing the incidence of complications. Methods The clinical data of 351 patients receiving LC was analyzed retrospectively. Results In 351 patients of LC,4 cases of bile leakages,5 cases of extra-hepatic bile duct injury,1 case of abdominal bleeding,1 case of subcutaneous emphysema,2 cases of residual bile duct stones,2 cases of peritoneal abscess,4 cases of postoperative vomiting, 1 case of cholecystalgia, to take the correct treatment and nursing care strategy, the patients were cured and discharged. Conclusions Strict control of surgical indications, master the surgical technique, be careful in operation, with particular attention to the anatomical variation of che Calot triang!e, timely laparotomy, close observation of changes in condition after the surgery, early detection of complications and deal with it correctly.