Zehetner Jörg, Shamiyeh Andreas, Wayand Wolfgang
Department of Surgery, Ludwig Boltzmann Institute for Operative Laparoscopy, AKH Linz, Krankenhausstrasse 9, 4020 Linz, Austria.
Am J Surg. 2007 Jan;193(1):73-8. doi: 10.1016/j.amjsurg.2006.05.015.
Laparoscopic cholecystectomy (LC) has been the gold standard for symptomatic gallstones for 15 years. During that time, several studies and case reports have been published which outline the possible complications of lost gallstones. The aim of this review is to categorize these complications and to evaluate the frequency and management of lost gallstones.
A Medline search from 1987 to 2005 was performed. A total of 111 case reports and studies were found, and all reported complications were listed alphabetically. Eight studies with more than 500 LCs that reported lost gallstones and perforated gallbladder were analyzed for frequency and management of lost gallstones.
Lost gallstones have a low incidence of causing complications but have a large variety of possible postoperative problems. Every effort should be made to remove spilled gallstones to prevent further complications, but conversion is not mandatory.
15年来,腹腔镜胆囊切除术(LC)一直是治疗有症状胆结石的金标准。在此期间,发表了多项研究和病例报告,概述了胆囊结石遗留可能引发的并发症。本综述的目的是对这些并发症进行分类,并评估胆囊结石遗留的发生率及处理方法。
检索了1987年至2005年的医学文献数据库(Medline)。共找到111篇病例报告和研究,所有报告的并发症均按字母顺序列出。对8项涉及500多例腹腔镜胆囊切除术且报告了胆囊结石遗留和胆囊穿孔情况的研究,分析了胆囊结石遗留的发生率及处理方法。
胆囊结石遗留导致并发症的发生率较低,但术后可能出现的问题多种多样。应尽一切努力清除溢出的结石以防止进一步的并发症,但不一定需要转为开腹手术。