摘要：
目的 提高腹腔镜胆囊切除术(LC)的认识水平,减少严重并发症的发生.方法 回顾性分析该院2008年1月—2017年12月4 051例LC病例中16例损伤性并发症的患者资料,探讨损伤的主、客观因素.结果 慢性结石性胆囊炎7例中,术后出血2例,术中发现胆总管损伤2例,十二指肠损伤1例,术后胆汁性腹膜炎2例.急性结石性胆囊炎或慢性结石性胆囊炎急性发作9例,术后出血2例,术中发现胆管损伤2例,十二指肠损伤2例,术后胆汁性腹膜炎3例.明确胆汁性腹膜炎在术后30～120 h.出血均再次经腹腔镜探查止血.胆管损伤根据发现的时间和损伤类型作不同的术式处理.所有患者随访1～8年,平均(45.3±9.2)个月,均恢复满意.结论 腹腔镜胆囊切除术存在着潜在的巨大风险,临床医生的认识水平和对待异常情况的处理态度极大的影响患者的诊疗结果.%Objective To improve the awareness level of LC and reduce the occurrence of severe complications. Methods The data of 16 cases from 4 051 cases of LC cases in our hospital from January 2008 to December 2017 were reviewed, and the subjective and objective factors were studied. Results There were 2 cases with postoperative bleeding after surgery, 2 cases with common bile duct injury in operation, 1 case with duodenal injury and 2 case with biliary peritonitis after surgery of 7 cases with chronic calculous cholecystitis, and there were 9 cases with acute calculous cholecystitis or chronic calculous cholecystitis acute attack, 2 cases with postoperative hemorrhage, and there were 2 cases with bile tract injury, 2 cases with duodenal injury in operation, and 3 cases with biliary peritonitis after surgery, and the bile peritonitis was cleared in 30-120 hours after surgery, and all patients were given the second laparoscopic exploration for hemostasis, and the bile tract injury was handled according to the discovery time and injury type, and all patients were followed up for 3-8 years, (45.3±9.2) months on average, and all patients were satisfied with the recovery. Conclusion The laparoscopic cholecystectomy has a potential great risk, and the awareness level and handing attitude towards the abnormal conditions of clinical doctors greatly affect the diagnosis and treatment results of patients.
