小切口胆囊切除术10 200例的并发症及预防
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张光全

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Minilaparotomy cholecystectomy:prevention of complications in 10 200 cases
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    摘要:

    目的:探讨小切口胆囊切除术(MC)并发症发生的原因及预防措施。
    方法:回顾分析15年间施行的10 200例MC患者的临床资料。
    结果:全组MC手术成功9 835例(96.4%),延长切口365例(3.6%)。严重并发症:胆道损伤12例(0.12%),横结肠损伤4例(0.04%),术中大出血8例(0.08),胆瘘25例(0.25%)。死亡4例(0.04%)。
    结论: 严格选择MC适应证,仔细分辩Calot三角解剖结构,应用缝扎胆囊三角系膜和深部打结技术,把握术中延长切口的时机是预防并发症的关键;反之则是本技术产生并发症的原因。

    Abstract:

    Abstract: Objective:To investigate the causes of and prophylactic measure for complications of minilaparotomy cholecystectomy (MC).
    Methods :The clinical data of 10 200 patients receiving MC from Apri1 1991 to March 2006 were analyzed.
    Results:MC was successful in 9 835 cases(96.4%), and in 365 cases(3.6%) the incision was lengthened. Serious complications were 12 cases(0.12%)of bi1e duct injury, 4 cases(0.04%)of colon injury, 8 cases(0.08%)of massive haemorrhage, and 25 cases (0.25%)of bile leakage. Four 4 cases(0.04%) died.
    Conclusions:The key to prevention of complications is a strict selection of MC indications,careful identification of the anatomical structures of Calot's triangle,use of suture ligation of the mesentery of gallbladder triangle and the technique of deep knot-tying and the timely use of extension of the incision.

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张光全,徐荣华,廖忠,吴先麟,程泰煦,何方,廖国庆.小切口胆囊切除术10 200例的并发症及预防[J].中国普通外科杂志,2007,16(2):4-.
DOI:10.7659/j. issn.1005-6947.2007.02.004

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  • 在线发布日期: 2007-02-25