腹腔镜胆囊切除手术中结石漏入腹腔的原因及处置
胆囊切除术,腹腔镜；并发症,,胆囊切除术，腹腔镜；并发症,1资料与方法,2结果,3讨论,参考文献：
【摘要】 目的：探讨腹腔镜胆囊切除术(LC)中结石漏入腹腔发生的原因及预防。方法：回顾分析512例LC术中结石漏入腹腔患者发生的原因，探讨其预防措施及处理经验。结果：LC术中结石漏入腹腔32例，结石漏入腹腔发生率为6.25%。LC术中结石漏入腹腔后多全部取出，腹腔残留结石患者无腹腔脓肿及窦道形成等并发症出现。结论：预防腹腔漏入结石的关键是LC术中防止胆囊分破或取出时撕破致胆汁、结石漏入腹腔，胆囊分破、结石落入腹腔后采取必要的处理措施，LC术中结石落入腹腔未能全部取出，可严密随访，不必为此中转开腹。【关键词】 胆囊切除术，腹腔镜；并发症
Reasons and administrative ways of gallstone spilling in peritoneal cavity during laparoscopic cholecystectomy
LIU Tianxue,XU Changqing,ZHANG Guiru,et al.
Department of General Surgery,the People′s Hospital of Penglai,Penglai,265600,China
【Abstract】 Objective:To investigate the reasons and administrative ways of spilling gallstone in peritoneal cavity during laparoscopic cholecycstectomy(LC).Methods:512 patients with gallstone spillage into peritoneal cavity during LC were retrospectively analysed in our unit,and the successfull experiences were summed up for prevention.Results:In this group,there were 32 patients with gallstone spillage during LC,and the incidence of gallstone spillage was about 6.25%.Following up half5years,there were not complications secondary to these spilled stones such as peritoneal abscess,stone migration through retroperitoneum to a previous surgical wound or mechanical small obstruction.Conclusions:The key step to prevent concretions seeped into abdominal cavity is to avoid gallbladder teared,which leading bile and concretions seep into abdominal cavity.The emergency action to this condition must be taken.However,it is not recommended to perform laparotomy in order to remove all spillage gallstones during LC because most retained stones are harmless to patients. ......
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