Brueggemeyer M T, Saba A K, Thibodeaux L C
Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA.
JSLS. 1997 Apr-Jun;1(2):145-52.
Our purpose was to report the occurrence of abscess following spilled gallstones during laparoscopic cholecystectomy as experienced at Good Samaritan Hospital, and to compare it to the experience of other institutions in order to identify the incidence, characteristics and possible risk factors for the development of this complication.
Four case reports of abscess following spilled gallstones during laparoscopic cholecystectomy are presented. The English literature was reviewed, and characteristics of the case reports found in the literature were compared.
In four years at this institution, four reports of abscess formation following laparoscopic cholecystectomy have been identified. Two occurred in elderly females and were located in the right flank in both. Two were in middle-aged men, both diabetic. One abscess was in the right flank and one in the right pleural space. Twenty-three cases were found in the literature. The average age was 65 years; there were 12 men and 11 women. The locations of abscess formation were trocar sites (most common), right subphrenic space, right flank or retroperitoneum, and pelvis. The average time to presentation was 4-5 months (range 4 days-12 months).
Abscess formation following spilled gallstones during laparoscopic cholecystectomy occurs infrequently, but can be debilitating and require more than one procedure. The older population appears to be at greater risk. Future prospective studies of patients who undergo laparoscopic cholecystectomy are needed to more accurately determine the incidence of this complication and to identify the population at risk.
我们旨在报告在撒玛利亚医院所经历的腹腔镜胆囊切除术中胆结石溢出后脓肿的发生情况，并将其与其他机构的经验进行比较，以确定这种并发症发生的发生率、特征和可能的危险因素。
呈现了4例腹腔镜胆囊切除术中胆结石溢出后脓肿的病例报告。对英文文献进行了回顾，并比较了文献中发现的病例报告的特征。
在该机构的4年中，已确定4例腹腔镜胆囊切除术后脓肿形成的报告。2例发生在老年女性，均位于右侧胁腹。2例发生在中年男性，均患有糖尿病。1例脓肿位于右侧胁腹，1例位于右侧胸腔。文献中发现23例。平均年龄为65岁；男性12例，女性11例。脓肿形成的部位为套管针穿刺部位（最常见）、右膈下间隙、右侧胁腹或腹膜后以及骨盆。出现症状的平均时间为4 - 5个月（范围为4天至12个月）。
腹腔镜胆囊切除术中胆结石溢出后脓肿形成虽不常见，但可能使人虚弱，且需要不止一次手术。老年人群似乎风险更高。需要对接受腹腔镜胆囊切除术的患者进行未来的前瞻性研究，以更准确地确定这种并发症的发生率，并确定高危人群。
