腹腔镜胆囊切除术后腹胀原因分析

目的　分析腹腔镜胆囊切除术后发生不同程度腹胀的原因 ,指导临床治疗。方法　回顾性分析我院1998-2 0 0 2年单纯行腹腔镜胆囊切除术后出现腹胀的 2 9例患者的临床资料。结果　轻度腹胀 19例 ,中度腹胀 7例 ,重度腹胀 3例。中重度腹胀的原因为困难复杂的腹腔镜胆囊切除术、手术时间超过 3 0分钟 14例 ;腹腔内积气 4例 ;术前未插胃管 4例 ;术后疼、下地活动迟 10例 ;术中见腹腔内炎症渗出 4例 ;分破胆囊、胆汁漏出 3例 ;术后胆囊床渗胆汁 1例 ;脏器浆肌层损伤 1例 ;低钾血症 1例。结论　轻度腹胀较常见 ,中重度腹胀提示可能有某些并发症的发生。

Analysis of postoperative abdominal distention in laparoscopic cholecystectomy

Objective To analyze the cause of different degree postoperative abdominal distention in laparoscopic cholecystectomy in order to clinical treatment.Methods The clinical data of 29 cases with postoperative abdominal distention in laparoscopic cholecystectomy were retrospectively analyzed.Results The mild,moderate,marked abdominal distention were 19,7,3 cases respectively.The causes of moderate and marked abdominal distention were difficult laparoscopic cholecystectomy and operation-time over 30min in 14 cases,intra-peritoneal free air in 4 cases,not nasogastric intubation in 4 cases,late postoperative activity in 1 cases,serous inflammatory exudation in 4cases,rupture cholecyst in 3 cases,biliary leak in 1 cases,injury of bowel muscular layer in 1 cases,hypokalemia in 1 cases.Conclusions Mild abdominal distention were more common, moderate and marked abdominal distention may be occur complication.