对开腹胆囊切除术后猝死原因的法医学分析研究

目的:从法医病理学角度剖析开腹胆囊切除(Open cholecystectomy,OC)后猝死的原因,分析总结引起其猝死的各种因素和预防措施,为防范医疗纠纷提供借鉴.方法:采用回顾性研究的方法,分析14例OC后猝死病例,通过回顾分析10年文献报道,对其猝死的原因及引发医疗纠纷的原因进行总结.结果:14例开腹胆囊切除术后猝死原因包括重症急性胰腺炎(57%)、胆囊床脓肿合并多器官功能障碍综合征(36%)及胆道损伤(7%)等.结论:早期诊断和治疗胆源性胰腺炎,积极有效地防治术前、术中和术后感染等并发症,提高医务人员业务水平和服务质量,加强医患沟通,有利于防范和减少胆囊术后猝死和医疗纠纷的发生.

A study of forensic pathology on sudden death after open cholecystectomy

Objective:To investigate the causes of sudden death after open cholecystectomy in the forensic pathology aspect and analyze the factors leading to sudden death in order to prevent complications and medical tangle. Methods: By the retrospective study , 14 cases of sudden death after open cholecystectomy were collected and analyzed. . The causes of death and medical tangle were summarized retrospectively by analyzing the past ten years report. Results: The causes of death included severe acute pancreatitis(57%), gallbladder abscess complicated by multiple organ dysfunction syndrome (36%) and bile duct injury (7%) and so on. The causes of medical tangle were due to poor attitudes and skills of the medical staff and being lack of adequate communications between patients and doctors. Conclusion: Diagnosing and treating gallstone pancreatitis at the early stage, preventing all kinds of complications including infections, improving the staff's service and skills, and promoting communications with the patients and relatives could help to reduce and prevent sudden death after open cholecystectomy and medical tangle.