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腹腔镜胆囊切除术后引流并发症之腹壁血肿:一例报告

Abdominal wall hematoma as a complication of drainage after laparoscopic cholecystectomy: a case report.

作者信息

Li Juntao, Liu Zixiong, Li Jia, Cheng Wei

机构信息

Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China.

出版信息

Front Med (Lausanne). 2025 Feb 12;12:1468200. doi: 10.3389/fmed.2025.1468200. eCollection 2025.

DOI:10.3389/fmed.2025.1468200
PMID:40012980
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11861199/
Abstract

BACKGROUND

Abdominal wall hematoma represents a potential postoperative complication that requires prompt identification and appropriate management. This case report retrospectively analyzes a patient who developed an abdominal wall hematoma associated with a drainage tube and puncture site following laparoscopic cholecystectomy at our hospital. The clinical characteristics, treatment modalities, and relevant literature are reviewed to highlight strategies for the prevention and management of postoperative hematomas, with the aim of providing valuable insights for clinical practice. We managed a patient who had undergone laparoscopic cholecystectomy for gallstones complicated by cholecystitis. On the first postoperative day, a hematoma developed at the site of the abdominal drainage tube insertion. Despite initial attempts at hemostasis through abdominal wall compression, these measures proved ineffective, necessitating the use of a urinary catheter balloon for effective compression hemostasis.

CASE PRESENTATION

We treated a patient who had undergone laparoscopic cholecystectomy for gallstones complicated by cholecystitis. On the first postoperative day, a hematoma developed at the site of the abdominal drainage tube insertion. Despite initial attempts at hemostasis using abdominal wall compression, these measures were ineffective, necessitating the use of a urinary catheter balloon for effective compression hemostasis.

CONCLUSION

The urinary catheter balloon tamponade was effectively employed postoperatively to achieve hemostasis for the hematoma at the abdominal wall drainage site. It provides a viable alternative for early intervention in hematoma management.

摘要

背景

腹壁血肿是一种潜在的术后并发症,需要及时识别并进行适当处理。本病例报告回顾性分析了我院一名在腹腔镜胆囊切除术后出现与引流管及穿刺部位相关的腹壁血肿的患者。对其临床特征、治疗方式及相关文献进行综述,以突出术后血肿的预防和处理策略,旨在为临床实践提供有价值的见解。我们诊治了一名因胆结石合并胆囊炎接受腹腔镜胆囊切除术的患者。术后第一天,在腹壁引流管插入部位出现了血肿。尽管最初尝试通过腹壁压迫进行止血,但这些措施无效,因此需要使用尿管球囊进行有效压迫止血。

病例介绍

我们治疗了一名因胆结石合并胆囊炎接受腹腔镜胆囊切除术的患者。术后第一天,在腹壁引流管插入部位出现了血肿。尽管最初尝试使用腹壁压迫止血,但这些措施无效,因此需要使用尿管球囊进行有效压迫止血。

结论

术后有效地使用尿管球囊压迫实现了腹壁引流部位血肿的止血。它为血肿处理的早期干预提供了一种可行的替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/7f0e18892fcf/fmed-12-1468200-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/735c049b4e85/fmed-12-1468200-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/52fbf395b904/fmed-12-1468200-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/7f0e18892fcf/fmed-12-1468200-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/735c049b4e85/fmed-12-1468200-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/52fbf395b904/fmed-12-1468200-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/10a6/11861199/7f0e18892fcf/fmed-12-1468200-g003.jpg

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本文引用的文献

1
Successful Transcatheter Arterial Embolization of Abdominal Wall Hematoma from the Left Deep Circumflex Iliac Artery after Abdominal Paracentesis in a Patient with Liver Cirrhosis: Case Report and Literature Review.经皮腹腔穿刺术后肝硬化患者左旋髂深动脉致腹壁血肿的成功经导管动脉栓塞治疗:病例报告及文献复习。
Korean J Gastroenterol. 2024 Apr 25;83(4):167-171. doi: 10.4166/kjg.2024.030.
2
Assessing incidence and risk factors of laparoscopic cholecystectomy complications in Jeddah: a retrospective study.吉达腹腔镜胆囊切除术并发症的发生率及危险因素评估:一项回顾性研究
Ann Med Surg (Lond). 2023 May 3;85(6):2749-2755. doi: 10.1097/MS9.0000000000000720. eCollection 2023 Jun.
3
Axillary, Chest Wall and Abdominal Hematoma as a Rare Complication of Radial Artery Catheterization.
腋部、胸壁及腹部血肿作为桡动脉置管的罕见并发症
Am J Case Rep. 2018 Dec 5;19:1441-1444. doi: 10.12659/AJCR.909091.
4
Single incision laparoscopic cholecystectomy: A review on the complications.单孔腹腔镜胆囊切除术:并发症综述
J Minim Access Surg. 2012 Jan;8(1):1-5. doi: 10.4103/0972-9941.91771.
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Complications of laparoscopic cholecystectomy: our experience in a district general hospital.腹腔镜胆囊切除术的并发症:我们在一家地区综合医院的经验。
Surg Laparosc Endosc Percutan Tech. 2009 Dec;19(6):449-58. doi: 10.1097/SLE.0b013e3181bd8f6d.
6
Systematic review: open, small-incision or laparoscopic cholecystectomy for symptomatic cholecystolithiasis.系统评价:开放性、小切口或腹腔镜胆囊切除术治疗有症状的胆囊结石
Aliment Pharmacol Ther. 2009 Feb 15;29(4):359-78. doi: 10.1111/j.1365-2036.2008.03894.x. Epub 2008 Nov 14.
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Conservative treatment of a huge abdominal wall hematoma after laparoscopic appendectomy.腹腔镜阑尾切除术后巨大腹壁血肿的保守治疗
J Laparoendosc Adv Surg Tech A. 2005 Dec;15(6):634-7. doi: 10.1089/lap.2005.15.634.
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Open port placement of the first laparoscopic port: a safe technique.首个腹腔镜端口的开放放置:一种安全技术。
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Complication of prophylactic intraperitoneal drainage.预防性腹腔引流的并发症
Dig Dis Sci. 2001 Nov;46(11):2456. doi: 10.1023/a:1012375903827.
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