腹腔镜胆囊切除术严重并发症的预防与处理

目的:探讨腹腔镜胆囊切除术的严重并发症的处理方法和效果.方法:回顾性分析1999年～2011年我院所收治的3 687例胆结石病例的临床资料.结果:3 687例病例中,3 515例(95.33%)患者实施腹腔镜胆囊切除手术治疗,其中3 492例(99.34%)顺利完成手术,23例(0.65%)中转开腹;17例(0.48%)出现严重并发症,主要表现为胆道、胃肠道损伤及术后出血.17例患者术中或术后经积极处置均治愈出院.结论:规范的岗前培训、熟练的传统开腹经历是开展腹腔镜胆囊切除术的前提,术前的评估、术中的规范操作以及对中转开腹时机的把握是有效避免或者减少并发症发生的关键.

Management and Prevention of Major Complications During Laparoscopic Cholecystectomy

Objective：To investigate the causes and managements for complications of laparoscopic cholecystectomy.Methods：From 1999 to 2011,3687 cases of laparoscopic cholecystectomy were analyzed and summarized retrospectively.Results：In 3687 cases of laparoscopic cholecystectomy,3515（95.33%） were successfully completed.There were 23（0.65%） cases with conversion from laparoscopic surgery to laparotomy.Seventeen（0.48%） of these 3687 cases were associated with serious complications,such as common bile duct injury and postoperative bleeding occurred.All patients were cured.Conclusions：The standard pre-service training,cautious operation and reasonable operation skill are required in precaution operative complications.The option of adaptive disease and shifting operation type will reduce obviously occurring of the operative complication.