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急性胆囊穿孔所致大量腹腔内出血的腹腔镜处理

Laparoscopic management of massive intraperitoneal haemorrhage caused by an acute gallbladder perforation.

作者信息

Lee Seokyoun, Kwon Jungnam, Kim Keunyoung

机构信息

Department of Surgery, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea.

Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea.

出版信息

J Minim Access Surg. 2018 Jan-Mar;14(1):65-67. doi: 10.4103/jmas.JMAS_98_17.

Abstract

Laparoscopic cholecystectomy is the gold standard for managing the treatment of patients with symptomatic gallstone disease. Certain patients with acute cholecystitis will develop gallbladder perforation (GP). Furthermore, massive intraperitoneal haemorrhage following perforation is a rare complication. The high morbidity and mortality rates associated with this condition are due to delays in the diagnosis and treatment since signs and symptoms of perforation do not differ significantly from those of uncomplicated cholecystitis. Severe inflammation and haemodynamic instability necessitate exploratory laparotomy in many patients. To the best of our knowledge, no study had described laparoscopic completion cholecystectomy for massive intraperitoneal haemorrhage caused by an acute GP. Laparoscopy can be an option for the management of these patients, in selected cases and with available expertise.

摘要

腹腔镜胆囊切除术是治疗有症状胆结石疾病患者的金标准。某些急性胆囊炎患者会发生胆囊穿孔(GP)。此外,穿孔后大量腹腔内出血是一种罕见的并发症。与这种情况相关的高发病率和死亡率是由于诊断和治疗的延迟,因为穿孔的体征和症状与非复杂性胆囊炎的体征和症状没有显著差异。严重炎症和血流动力学不稳定使得许多患者需要进行剖腹探查术。据我们所知,尚无研究描述针对急性胆囊穿孔引起的大量腹腔内出血进行腹腔镜胆囊切除术。在特定病例且具备可用专业知识的情况下,腹腔镜检查可以作为这些患者治疗的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2ec/5749201/ae8231218c43/JMAS-14-65-g001.jpg

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