腹腔镜胆囊切除术并发症的预防

腹腔镜胆囊切除术(LC)自20世纪80年代末应用于临床以来,经过10余年的发展,这一新技术已得到广泛使用,主要是由于这一技术具有创伤小、痛苦轻、恢复快和安全可靠等优点,已经作为外科治疗胆囊炎等良性疾病的首选方法,并得到国内外学者的认可。随着操作技术的逐渐成熟,手术器械的更新,适应证不断扩大。要安全地完成LC,一定要做好以下几方面工作:根据术者实际水平选择适当的适应证;评价患者心肺功能,完善术前准备工作,预防心肺功能损害;术中操作准确,防止穿刺损伤,胆管损伤以及意外出血;适时选择中转开腹,以保证手术的顺利进行;手术结束时尽量排空腹腔内残余二氧化碳,减少肩部疼痛和恶心、呕吐等并发症的发生。

Prevention of Complications of Laparascopic Cholecystectomy

With the development about 10 years since its application in clinic in 1980,Laparoscopic cholecystectomy(LC) has been applied widely,which is being approved by internal doctors as the first choice in surgical treatment of innocuousness changes such as cholecystitis becausse of mainly its many advantages including mini trauma,lesser pains,rapid recovery, safety and reliability With the gradually maturity of operating skills, the update of surgical instruments,ever expanding of surgical indications , several aspects of tasks as followed should be well recognized and prepared in order to safely complete the LC,which icludes in collecting the proper and correct indications according to the actual skill level of the operators;evaluating patients' cardiorespiratory function,promoting preoperative preparations,preventing the cardiorespiratory function damage; operating accurately during the operation to get rid of puncturative injury ,bile ducts injury and accidental bleeding ;selecting regular abdominal surgery in appropriate time to ensure the success of the surgery; emptying the remnant CO2 in the abdominal cavity at the end of the surgery and reducing incidence of the shoulder pains, nausea and vomit and other complications.