腹腔镜胆囊切除术并发症的防治体会

目的回顾性探讨腹腔镜胆囊切除术发生并发症的原因及防治方法。方法回顾性分析2004年1月至2009年3月间1749例腹腔镜胆囊切除的并发症及处理措施。其中胆总管横断2例,迷走胆管损伤4例,胆总管夹闭1例,腹腔出血2例,胆总管残余结石2例,胆囊管残端瘘1例。结果本组患者均通过手术治疗或保守治疗治愈出院。结论完善的术前检查,严格规范的操作,胆囊三角良好的显露,辨清肝总管、胆总管和胆囊管之间的关系,及时果断中转开腹,是避免腹腔镜胆囊切除术发生并发症的关键。

The Prevention of the Complications of Laparoscopic Cholecystectomy

Objective To explore the reason and prevention measurements of the complications of laparoscopic cholecystectomy. Methods 1749 patients underwent laparoscopic cholecystectomy in our hospital from 2004 Jan. to 2009 Mar. were retrospectively analyzed. Transection of common bile duct in 2 cases, the vagus bile duct injury in 4 cases, common bile duct occlusion in 1 case, abdominal bleeding, 2 cases of residual common bile duct stones in 2 cases, cystic duct stump fistula in 1 case. Results All the patients recovered after operation or nonoperation treatment. Conclusion Identified the relationship among liver mains, common bile duct and cystic duct between the timely and decisive transit laparotomy, is the key points to prevent the complications of laparoscopic cholecystectomy.