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胆囊结石溢出继发腹壁脓肿:腹腔镜胆囊切除术的晚期并发症及预防措施

Abdominal wall abscess secondary to spilled gallstones: late complication of laparoscopic cholecystectomy and preventive measures.

作者信息

Yao C C, Wong H H, Yang C C, Lin C S

机构信息

Department of Surgery, Min-Shen General Hospital, Taoyuan, Taiwan, Republic of China.

出版信息

J Laparoendosc Adv Surg Tech A. 2001 Feb;11(1):47-51. doi: 10.1089/10926420150502959.

Abstract

Spilled gallstones left in the abdominal cavity or trapped at trocar sites may cause considerable morbidity. We saw a patient with an abdominal wall abscess 2 years after laparoscopic cholecystectomy secondary to spilled stones. After we reviewed the operative procedure in addition to the accumulated experience in laparoscopic surgery, we believe that retrieval of specimens and their contents is of paramount importance, especially when the gallbladder is infected, contains several stones, or may harbor malignancy. Therefore, we made use of a simple surgical glove with a long pursestring suture surrounding the opening to collect the specimen. This method proved to be simple and quite convenient, with the needed materials readily available. It can collect the spilled stones within the abdominal cavity as well as the gallbladder and can transport these stones out of the abdominal cavity with ease and safety. It also protects the specimen in contact with the wound and cuts short the operating time. The technique and advantages are described.

摘要

遗留在腹腔内或被困于套管针穿刺部位的胆囊结石可能会导致相当严重的发病情况。我们曾见过一名患者,在腹腔镜胆囊切除术后两年因结石残留而出现腹壁脓肿。在回顾手术过程以及积累的腹腔镜手术经验后,我们认为取出标本及其内容物至关重要,尤其是当胆囊受到感染、含有多个结石或可能存在恶性病变时。因此,我们采用了一种简单的手术手套,在开口处环绕一根长的荷包缝线来收集标本。这种方法被证明简单且非常方便,所需材料易于获取。它能够收集腹腔内以及胆囊中的溢出结石,并能轻松安全地将这些结石运出腹腔。它还能保护与伤口接触的标本,并缩短手术时间。本文描述了该技术及其优点。

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