【摘要】 目的对腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)术医源性损伤发生的原因及其防治对策进行探讨。方法回顾分析我院1326例LC术患者的临床资料,总结其发生医源性损伤的经验教训。结果 10例(0.75%)发生医源性损伤,腹腔出血5例(0.38%)、胆管损伤2例(0.15%)、胆漏2例(0.15%)、十二指肠损伤1例(0.08%),经相应处理,均术后痊愈出院,无死亡病例。结论腹腔出血、胆管损伤、胆漏、十二指肠损伤是LC术常见医源性损伤。熟练掌握LC术手术技巧,术前认真选择病例,严格掌握手术适应证,术中充分有效的暴露、Colot三角的精细解剖、对组织准确的辨认,及时中转开腹,规范的手术操作是我们预防腹腔镜胆囊切除术医源性损伤的重要措施。以高度的责任心,积极预防和治疗LC术医源性损伤,努力提高LC手术正确性、安全性,使其治疗效果更令人满意。更多还原

【Abstract】 Objective Laparoscopic cholecystectomy (laparoscopic cholecystectomy,LC) discussion on the causes and prevention of iatrogenic injury. Methods Retrospective analysis of Clinical data in 1326 LC patients,summarizing lessons of iatrogenic injury. Results 10 cases (0.75%),iatrogenic injury,abdominal hemorrhage in 5 cases (0.38%),2 cases of bile duct injury (0.15%),2 cases of bile leakage (0.15%) and duodenal injury in 1 case (0.08%),as appropriate,were discharged after surgery,no death. Conclusion Abdominal bleeding,biliary,duodenal biliary leakage damage,injuries were common iatrogenic injury during LC. Familiar LC with surgical techniques,preoperative carefully selected cases,strict control indications for surgery,full and effective exposure,colot fine Anatomy,accurate identification for the Organization of the triangle,conversion to open in a timely manner,standard procedure is to prevent iatrogenic injuries in laparoscopic cholecystectomy of important measures. With a high degree of responsibility,prevention and treatment of iatrogenic injury during LC,efforts to improve the security operation accuracy,LC,make them more satisfactory treatment.更多还原