腹腔镜胆囊切除术后近期再手术18例分析

目的 探讨腹腔镜胆囊切除术严重并发症的防治。方法 回顾性研究我院1993年以来腹腔镜胆囊切除术后近期再次手术病例18例。结果 肝外胆管损伤、胆囊管残端漏、腹腔内残余感染、胆总管残留结石、出血是最常见并发症，18例患者经再次手术均治愈出院。结论 术前严格选择适应证、术中精细操作是减少腹腔镜胆囊切除术并发症的前提，术后严密观察病情，准确把握再次手术指征及时机是避免后遗症的关键。

Analysis of 18 immediate re-operation cases after laparoscopic cholecystectomy

Objective To discuss the prevention and cure of the serious complications of laparoscopic cholecystectomy. Methods To study retrospectively 18 immediate re operation cases after laparoscopic cholecystectomy in our hospital since 1993.Results Extrahepatic bile duct injury, cystic duct stump leakage, intraperitoneal residual infection ,choledochus residual concretion and hemorrhage are the commonest complications. All of 18 cases had been cured after re operation.Conclusions Strictly selecting adaptations before operation and fine operating during operation are the precondition for decreasing the complications of laparoscopic cholecystectomy. Moreover, close observing states of illness and accurately judging the re operation indications and occasion are the key for avoiding the sequelaes.