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[腹腔镜胆囊切除术后并发症的微创治疗]

[Mini invasive treatment of complications following laparoscopic cholecystectomy].

作者信息

Duca S, al-Hajjar N, Bala O, Iancu C, Munteanu D, Graur F, Glijin V, Pascarenco G

机构信息

Centrul de instruire în Chirurgia Laparoscopică, Clinica Chirurgie III, U.M.F. Cluj.

出版信息

Chirurgia (Bucur). 2003 Sep-Oct;98(5):405-10.

Abstract

UNLABELLED

Miniinvasive treatment can be used in many early complications following laparoscopic cholecystectomy. In this article are analyzed the indications and the efficiency of these techniques.

MATERIAL AND METHODS

We analyzed here a group of 9542 laparoscopic cholecystectomy operated in 9 years. The main postoperative complications were: bile leak (54 cases), haemorrhage (15 cases), subhepatic abscess (10 cases) and early diagnosed remnant lithiasis of CBD (11 cases). Miniinvasive techniques that were used were laparoscopic reinterventions (15 cases) and EST (22 cases).

RESULTS

Classic reinterventions were practiced in 28.88% of cases with complications. Miniinvasive techniques were used in 42.2% of cases with complications: laparoscopic reinterventions (15 cases) for choleperitoneum, haemoperitoneum and subhepatic abscess and EST (22 cases) for prolonged bile leak on subhepatic drain and for early diagnosed remnant lithiasis of CBD. All cases were healed.

DISCUSSION

Along with a precise diagnosis and a good indication, the miniinvasive treatment of complications proved to have good results, converting the bad operative outcome into a postoperative success.

摘要

未标注

微创治疗可用于腹腔镜胆囊切除术后的许多早期并发症。本文分析了这些技术的适应症和疗效。

材料与方法

我们分析了9年中进行的9542例腹腔镜胆囊切除术。主要术后并发症有:胆漏(54例)、出血(15例)、肝下脓肿(10例)和早期诊断的胆总管残余结石(11例)。使用的微创技术有腹腔镜再次手术(15例)和内镜下括约肌切开术(EST,22例)。

结果

28.88%的并发症病例采用了传统的再次手术。42.2%的并发症病例使用了微创技术:腹腔镜再次手术(15例)用于治疗胆汁性腹膜炎、腹腔积血和肝下脓肿,EST(22例)用于治疗肝下引流管长期胆漏和早期诊断的胆总管残余结石。所有病例均治愈。

讨论

除了精确的诊断和良好的适应症外,并发症的微创治疗已证明效果良好,将不良的手术结果转化为术后成功。

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