腹腔镜胆囊切除术后远期并发症的临床分析

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后患者远期并发症的发生情况。方法:对247例LC患者术后进行长期随访,统计其远期并发症,并进行临床总结。结果:经过2～5年的随访,共发生LC相关的远期并发症68例,其中胆汁反流性胃炎27例,消化不良症状13例,胆管炎17例,胆总管结石16例,胆管良性狭窄10例。结论:LC存在较高的术后远期并发症发生率,术前必须严格把握手术适应证,对于可保守或继续观察的患者不要轻易行LC;术中仔细操作,遇疑难病例及时请上级医师介入或中转开腹,避免发生潜在的胆管损伤。

The clinical analysis of long-term complications after laparoscopic cholecystectomy

Objective： To evaluate the long-term complications after laparoscopic cholecystectomy（LC）.Methods： Long term follow-up for 2-5 years was assessed after the LC,in order to analyze and summarize the status of long-term complications.Results： Two hundred and forty-seven patients were followed up for 2-5 years,the long-term complications associated with LC occurred in 68 patients,including bile reflux gastritis（n = 27）,indigestion（n = 13）,cholangitis（n = 17）,choledocholithiasis（n = 16）,benign stricture of bile duct（n = 10）.Conclusions： There are high frequency of long-term complications after LC,surgeons should strictly master the indications and surgical skills of LC.LC should not easily be chosen for patients who should receive conservative treatment or observation.If cases are intractable,following procedures should be taken to avoid potential injury of bile duct： careful intraoperative manipulation,turning to superior doctors for help and conversion to laparotomy.