Al-Haijar Nadim, Duca Sergiu, Molnár Géza, Vasilescu Alin, Nicolescu Nicoleta
3rd Surgical Clinic, University of Medicine and Pharmacy, Croitorilor Str. no. 19-21, 3400 Cluj-Napoca, Romania.
Rom J Gastroenterol. 2002 Jun;11(2):115-9.
The purpose of this study was to analyze incidents and postoperative complications of the laparoscopic cholecystectomies performed for acute cholecystitis in 1453 patients in the 3rd Surgical Clinic, Cluj-Napoca. Hemorrhage occurred in 139 (9.5%) cases from which 75 (54%) lesions of the cystic artery, 63 (45.3%) cases of bleeding from the vesicular bed and 1 patient (0.72%) with section of the hepatic artery. Lesions of the bile ducts occurred in 13 (0.9%) patients from which 4 (3.07%) were on the right hepatic duct and 9 (6.93%) on the common bile duct. We encountered 152 (10.46%) early postoperative complications from which 92 (60.5%) were grade I, 56 (37%) grade II, 0 grade III and 4 (2.63%) grade IV, according to Clavien's classification. There were 35 (2.4%) nonspecific postoperative complications from which there where phlebitic reactions in 25 (71.4%) patients, phlebitis in 9 (25.7%) and upper digestive hemorrhage due to acutization of a duodenal ulcer in 1 patient (2.9%). We also registered a number of 20 (1.38%) later postoperative complications: 10 (50%) residual biliary lithiasis in the first postoperative year, and 10 (50%) hernias at the umbilical trocar insertion site.
本研究的目的是分析克卢日-纳波卡第三外科诊所对1453例急性胆囊炎患者实施腹腔镜胆囊切除术的术中情况及术后并发症。139例（9.5%）发生出血，其中75例（54%）为胆囊动脉损伤，63例（45.3%）为胆囊床出血，1例（0.72%）为肝动脉切断。13例（0.9%）患者发生胆管损伤，其中4例（3.07%）为右肝管损伤，9例（6.93%）为胆总管损伤。根据Clavien分类，我们共遇到152例（10.46%）早期术后并发症，其中I级92例（60.5%），II级56例（37%），无III级，IV级4例（2.63%）。有35例（2.4%）非特异性术后并发症，其中25例（71.4%）患者出现静脉炎反应，9例（25.7%）出现静脉炎，1例（2.9%）因十二指肠溃疡急性发作出现上消化道出血。我们还记录到20例（1.38%）晚期术后并发症：术后第一年10例（50%）残留胆管结石，10例（50%）脐部套管插入部位疝。
