腹腔镜胆囊切除术严重并发症的预防及处理

腹腔镜胆囊切除术已成为治疗胆囊良性疾病的标准术式,但其并发症发生率仍较高,胆管损伤、腹腔及腹膜后大血管损伤、术后胆漏、胃肠道损伤、术后出血等严重并发症给患者带来灾难性后果.术者经验不足、操作粗暴、解剖变异、局部粘连等为其发生的主要原因.建立准入制度、术者接受腹腔镜技术规范化培训、熟悉胆道外科常见解剖变异、术中仔细、轻柔操作对预防并发症的发生有重要意义,发生严重并发症后应早发现、早处理,根据患者具体情况采取个体化治疗方案.

Prevention and treatment of serious complications following laparoscopic cholecystectomy

Laparoscopic cholecystectomy （LC） has been considered as golden surgical proce dure for benign disease of gallbladder.However,its incidence rate of complications still remains high.Bile duct injury,abdominal and retroperitoneal great vascular injury,postoperative bile leakage,gas trointestinal injury and postoperative hemorrhage are most common serious complications,which cause fateful consequences on patients underwent LC procedures.Lack of surgical experience,rough opera tion,anatomical variation and adhesion are most common causes for occurrence of these complications.Building access system,laparoscopic technique training,being familiar with bile duct anatomical varia tion,gently and attentively performing during operation procedure may attribute to avoid these compli cations.Early surgical procedure and individualized treatment should be performed if these complica tions occurred.