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肠缺血：腹腔镜胆囊切除术后一种罕见且不常见的并发症——病例报告及文献综述

Intestinal ischemia: A rare and less common complication after laparoscopic cholecystectomy-A case report and literature review.

作者信息

Ghamari Mohammad Javad, Beyzaii Hamed, Bahraminejad Behnoush, Mesbah Narges, Sobhani Ahmadreza, Mirsadeghi Ali

机构信息

Department of General Surgery, Faculty of Medicine, Mashhad Medical Sciences Islamic Azad University Mashhad Iran.

Department of Anesthesiology, Faculty of Medicine, Mashhad Medical Sciences Islamic Azad University Mashhad Iran.

出版信息

Clin Case Rep. 2024 Sep 30;12(10):e9425. doi: 10.1002/ccr3.9425. eCollection 2024 Oct.

DOI:10.1002/ccr3.9425
PMID:39355769
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11442311/
Abstract

KEY CLINICAL MESSAGE

Patients with a history of persistent mesenteric ischemia should not undergo laparoscopy. Mesenteric ischemia must be kept in mind for patients who develop nonspecific abdominal symptoms following laparoscopic surgeries.

ABSTRACT

During laparoscopic cholecystectomy (LC), the rise in Intra-Abdominal Pressure due to carbon dioxide insufflation can reduce blood flow through splanchnic vessels, potentially leading to intestinal ischemia. A 72-year-old woman with a history of diabetes, hypertension, ischemic heart disease, and hyperlipidemia underwent LC. She was discharged but readmitted 4 days later due to peritonitis. Ischemic jejunum loops were found during surgery.

摘要

关键临床信息

有持续性肠系膜缺血病史的患者不应接受腹腔镜检查。对于腹腔镜手术后出现非特异性腹部症状的患者，必须考虑肠系膜缺血。

摘要

在腹腔镜胆囊切除术（LC）过程中，二氧化碳气腹导致的腹内压升高会减少内脏血管的血流，可能导致肠缺血。一名72岁有糖尿病、高血压、缺血性心脏病和高脂血症病史的女性接受了LC。她出院了，但4天后因腹膜炎再次入院。手术中发现缺血性空肠袢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e13/11442311/ad81963e98aa/CCR3-12-e9425-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e13/11442311/ad81963e98aa/CCR3-12-e9425-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e13/11442311/ad81963e98aa/CCR3-12-e9425-g001.jpg

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本文引用的文献

1
The "Dark Side" of Pneumoperitoneum and Laparoscopy.气腹与腹腔镜检查的“黑暗面”
Minim Invasive Surg. 2021 May 19;2021:5564745. doi: 10.1155/2021/5564745. eCollection 2021.
2
Portal vein thrombosis after laparoscopic cholecystectomy.腹腔镜胆囊切除术后门静脉血栓形成
JSLS. 2014 Jan-Mar;18(1):125-7. doi: 10.4293/108680813X13654754535674.
3
Intestinal ischemia following laparoscopic surgery: a case series.腹腔镜手术后的肠道缺血：病例系列
J Med Case Rep. 2013 Jan 21;7:25. doi: 10.1186/1752-1947-7-25.
4
Systematic review of oxidative stress associated with pneumoperitoneum.气腹相关氧化应激的系统评价
Br J Surg. 2009 Aug;96(8):836-50. doi: 10.1002/bjs.6651.
5
Portomesenteric venous thrombosis after laparoscopic surgery: a systematic literature review.腹腔镜手术后门静脉肠系膜静脉血栓形成：一项系统文献综述。
Arch Surg. 2009 Jun;144(6):520-6. doi: 10.1001/archsurg.2009.81.
6
Intestinal ischemia after laparoscopic cholecystectomy.腹腔镜胆囊切除术后的肠道缺血
JSLS. 2006 Apr-Jun;10(2):236-8.
7
Portal vein thrombosis: an unusual complication of laparoscopic cholecystectomy.门静脉血栓形成：腹腔镜胆囊切除术的一种罕见并发症。
JSLS. 2005 Jan-Mar;9(1):87-90.
8
Mesenteric ischemia affects young adults with predisposition.肠系膜缺血影响有易患倾向的年轻人。
Ann Vasc Surg. 2003 May;17(3):270-6. doi: 10.1007/s10016-001-0305-3. Epub 2003 Apr 28.
9
Does splanchnic ischemia occur during laparoscopic cholecystectomy?腹腔镜胆囊切除术期间会发生内脏缺血吗？
Surg Endosc. 2002 Mar;16(3):468-71. doi: 10.1007/s00464-001-9031-8. Epub 2001 Nov 16.
10
Small bowel ischemia following laparoscopic cholecystectomy.腹腔镜胆囊切除术后的小肠缺血
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