摘要
目的探讨腹腔镜胆囊切除术(LC)非创伤性并发症的预治措施。方法回顾分析1991年9月至2004年8月13 000例LC的临床资料。结果13 000例LC共发生非手术创伤性的并发症56例,其中遗漏腹腔内恶性肿瘤9例,胆总管残留结石47例。9例遗漏病变中,包括肝癌、胃癌各1例,胰腺癌、胆囊癌各2例,右半结肠癌3例。除3例右半结肠癌行根治性切除外,另6例已不能行根治性手术。47例胆管残留结石均治愈,其中31例经ERCP取石,16例行开腹胆道探查。结论术前注意鉴别患者的症状,术中注意观察胆囊的病理改变及腹腔内有无异常情况,必要时借助腹腔镜超声(LUS)等检查是避免LC后遗漏腹腔内恶性肿瘤及残留胆管结石等非手术创伤性并发症发生的有效方法。
Objective To investigate prophylactic measures for non-traumatic complications of laparoscopic cholecystectomy （LC）. Methods The data of 13 000 patients who underwent LC in Kunming general hospital of PLA over 13 years（1991-2004） were retrospectively reviewed. Results Nine malignant tumors and 47 common bile duct stones were missed at LC. The 9 malignant tumors included hepatic cancer （n=1）, gastric cancer （n=1）, gallbladder cancer （n=2）, pancreatic cancer （n=2） and right colon cancer （n=3）. Of all the carcinomas, 3 patients with right colon cancer underwent colectomy, the other 6 patients couldn＇t be cured radically. All the 47 patients with choledocholithiasis were cured successfully, among them 31 patients were performed with ERCP and 16 were re-operated on with cholangiotomy. Conclusion This study emphasizes the necessity to analyze carefully patients＇ symptoms before operation and pay attention to pathological changes of gallbladder and intraabdominal situation intraoperatively. If necessary, laparoscopic ultrosonography can be used to avoid missing malignant tumors and biliary stones.
出处
《中国普外基础与临床杂志》
CAS
2005年第6期558-560,共3页
Chinese Journal of Bases and Clinics In General Surgery
关键词
腹腔镜胆囊切除
非创伤性
并发症
预防
Laparoscopic cholecystectomy Non-traumatic Complication Prophylactic measure
