腹腔镜再手术处理腹腔镜胆囊切除术后并发症21例

目的探讨腹腔镜再处理腹腔镜胆囊切除术后并发症的价值。方法1996年10月～2007年10月，共行754例腹腔镜胆囊切除术，对21例术后并发症行再次腹腔镜探查。结果21例均在腹腔镜下明确诊断，其中胆漏11例，术后腹腔内出血6例，腹腔积液2例，十二指肠球部穿孔和术后黄疸各1例。除术后黄疸为肝总管横断中转开腹以外，余20例均在腹腔镜下完成手术。21例随访1—11年（平均6年），无胆道并发症发生。结论腹腔镜再手术处理腹腔镜胆囊切除术后并发症可行，创伤小，安全，有效。

Laparoscopy in Treatment of Post-laparoscapic Cholecystectomy Complications: Report of 21 Cages

Objective To investigate the value of laparoscopic treatment for post-laparoscopic cholecystectomy complications. Methods From October 1996 to October 2007, totally 754 patients suffering from gallbladder diseases underwent laparoscopic cholecystectomy in our hospital; 21 of them developed postoperative complications and received laparoscopic intraabdominal exploration. Results By laparoscopy, bile leakage was diagnosed in 11 cases, intra-abdominal bleeding in 6, intraperitoneal fluid in 2, duodenal bulb perforation in 1, and obstructive jaundice in 1. The patients who developed obstructive jaundice was converted to open surgery because of hepatic duct transection. The other 20 cases underwent laparoscopic treatment. All the patients were followed up for a mean of 6 years （ 1 to 11 ） , during which none of them had biliary complications. Conclusion Laparoscopic treatment is a microinvasive, safe and effective method for post-laparoscopic cholecystectomy complications.