目的 探讨腹腔镜胆囊切除术(LC)常见并发症的原因及防治措施.方法 对行腹腔镜胆囊切除术390例患者的临床资料进行回顾性分析.结果 382例患者经LC成功切除胆囊,手术成功率为97.9%.中转开腹8例,占2.1%,231例术后放置腹腔引流管,手术时间25～150 min,平均(42.5±6.3)min,术后住院时间3～5d,平均3.6d,7例发生并发症,其中胆道损伤、胆漏、切口感染各1例,结石残留及出血各2例,所有病例均治愈,无手术死亡病例.结论 全面的术前评估、严格把握手术适应证、规范的手术操作、适时的中转开腹及放置腹腔引流管是预防并发症的关键措施.%Objective To investigate the common causes of complications of laparoscopic cholecystectomy and its preventive measures. Methods To analyze the clinical materials of 390 patients who underwent LC during July of 2009 and December of 2010 retrospectively. Results 382 cases underwent LC successfully, which about 97.9％. Ony 8 idividuals turned to open cholecystectomy (OC) ,which about 2.1％ ,231 patients were put a drainage tube of the abdominal cavity afer operation,the surgical operation time was averagely (42.5 ±6.3) min,ranging from 25 to 150 min,the postoperative periods in hospital was averagely 3.6d,ranging from 3 to 5d. Complications occurred in 7 cases, which were bile duct harm in 1 case, biliary leakage in 1 case, postoperative wound infection 1 case, postoperative choledocholithiasis 2 cases and massive haemorrhage during operation 2 cases. All the cases were cured and no patients died. Conclusions Comprehensive preoperative assessment, selecting clinical indications strictly, standard operation, converting to open cholecystectomy promptly and putting a drainage tube into the abdominal cavity afer operation should be the key measures to prevent complications.
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