Loffeld R J L F
Department of Internal Medicine, Zaans Medical Centre, Zaandam, the Netherlands.
Neth J Med. 2006 Nov;64(10):364-6.
Laparoscopic cholecystectomy has become the preferred surgical technique for symptomatic gallstone disease. The technique generally is safe. probably one of the most common intra-operative complications is gallbladder perforation with stones spreading into the peritoneal cavity. In this paper the sequelae of lost gallstones after laparoscopic cholecystectomy and the diagnostic problems facing the clinician are reviewed. Abscesses and fistula formation in the abdominal wall occur. A long delay can be present between the initial operation and the complications of the lost stones. Although rupture of the gallbladder is usually noticed during preparation and retrieval, the surgeon may not be aware of losing stones. due to the long delay, the occurrence of intra-abdominal abscesses and fistula is often not linked to the prior procedure.
腹腔镜胆囊切除术已成为有症状胆结石疾病的首选手术技术。该技术一般是安全的。术中最常见的并发症之一可能是胆囊穿孔伴结石播散至腹腔。本文回顾了腹腔镜胆囊切除术后结石遗留的后遗症以及临床医生面临的诊断问题。腹壁会出现脓肿和瘘管形成。从初次手术到结石遗留并发症之间可能会有很长的延迟。虽然胆囊破裂通常在准备和取出过程中被注意到,但外科医生可能并未意识到结石遗留。由于延迟时间长,腹腔内脓肿和瘘管的发生往往与先前的手术没有关联。