腹腔镜胆囊切除术严重并发症的预防及处理.pdfVIP

腹部外科 2014 年第2H去第 3 期 Fu Bu Wai Ke, Jun. 201 4, Vo 1. 27 , No. 3 • 153 • 评 · · 述 腹腔镜胆囊切除术严重并发症的预防及处理 胡三元 E摘要】 腹腔镜胆囊切除术已成为治疗胆囊良性疾病的标准术式， 但其并发疲发生率仍较高，胆 管损伤、 腹腔及脏膜后大血笆损伤、术后阻漏、胃肠道损伤、术后出I缸等严重并发症给患者带来灾难性 后果。术者经验不足、 操作粗暴、 解剖变异、 局部粘连等为其发生的主要原因。建立i佳人制度、 术者接 受腹腔镜技术规范化培训、 熟悉胆道外科常见解剖变异、 术中仔细、 轻柔操作对预防并发症的发生有 重要意义，发生严重并发症后应早发现、早处理，根据患者具体情况采取个体化治疗方案。 E关键词】 胆囊切除术，腹腔镜;手术中并发症;术后并发症 [中图分类号] R657. 4 [文献标示码] A [以)IJ 10. 3969/j. iss n. 1003-5591. 2014 . 03. 00 1 Prevenlion and Ireatnlent of seriousωrnplicatiollS fO llowing laparosωpic c.holecyslectorny H u Sa.nyu.an. Deρdγtment 0/ Ceneral Suγgery ， Qilu. H ospital o/Shandong University , ] cllan 250012 , Chilla Corresponding author :H u Sanyu.an .Email :husanyu.an1962@hotmail . com [At巧tmct] Laparoscopic cholecystectomy (LC) has been consider ed as goJden surgical proce- dure for benign disease of ga llbladder . H owever , its incidence rate of complications still remains high. BiJe duct injury , abdominal and retroperitonea l great vascular inj ury , postoperative bile leakage , gas- tro intest inal injury and postoperative hemorrhage are most common serωus complications , which cause {atefu l consequences on patients underwent LC procedures. Lack of surgical experience, rough opera- tion , anatomica l va riation and adhesion are most common causes for occurrence of these complications. Building access system , lapaJ:oscopic technique training , being familiar with bile duct anatomical var ia- tion , gentl y and at tentively performing during operation procedure may attributeωavoid these compli- cations. Early surgica l procedure and individual ized t reatment should be performed if these complica- tions occu.rred. [ Kcy words Cholecystectomy , laparoscopic ;