腹腔镜_____胆囊切除术，腹腔镜；并发症;再手术

腹腔镜胆囊切除术后近期再手术的原因及对策(附19例报告)

http://www.100md.com 《腹腔镜外科杂志》 2006年第1期

腹腔镜,,胆囊切除术，腹腔镜；并发症;再手术,1资料与方法,2结果,3讨论

     【摘要】目的：探讨腹腔镜胆囊切除术(LC)后近期再手术的原因、手术方式及预防措施。方法：分析1995年至2004年6 016例LC术后再手术的19例患者的临床资料。结果：再手术的原因为胆总管损伤2例、腹腔内出血8例、胆总管残余结石7例、胆囊管残端漏2例。再手术方式分别为胆总管端端吻合术、胆总管空肠RouxenY吻合术、剖腹止血术、EST、胆总管切开取石术。19例均经手术治愈，未出现严重并发症。结论：减少LC术后再手术的关键是掌握好LC的适应证，术中精细操作，适时中转开腹，合理放置引流管。

    【关键词】胆囊切除术，腹腔镜；并发症;再手术

    The reasons and strategies of reoperation in the near future after laparoscopic cholecystectomy：with a report of 19 cases

    WU Wei.

    The People's Hospital of Tongling City,Tongling 244000,China

    【Abstract】 Objective:To explore the reasons,operationstyles and preventive measures of reoperation in the near future after LC.Methods:The clinic data of 19 patients who had been reoperated in 6 016 cases of LC from 1995 to 2004 were analyzed.Results:Reasons of reoperation were as follows:2 cases were injured in common bile duct; 8 cases were intraperitoneal hemorrhage; 7 cases were retained calculus in common bile duct; 2 cases were cystic duct fistula.The reoperationstyles were as follows: choledochocholedochostomy,RouxenY choledochojejunostomy,laparotomy of hematischesis,EST,choledocholithotomy.19 cases were all cured by operations without severe complication.Conclusions:The keys to reduce the rate of reoperation are controlling the indication of LC,operating carefully,using laparotomy when necessary and placing the drain rationally. ......

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