腹腔镜胆囊切除术后胆囊床积液的处理体会

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。

The postoperative hydrops of gallbladder bed of laparoscopic cholecystectomy

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.