腹腔镜胆囊切除术后胆漏原因及防治

发布时间：2018-06-28 09:04

本文选题：腹腔镜胆囊切除术 + 胆漏　；参考：《重庆医科大学》2015年硕士论文

【摘要】：腹腔镜下胆囊切除术(laparoscopic cholecystectomy, LC)是目前创伤最小的胆囊切除术,具有伤口小、对腹腔内脏器干扰小、术后恢复快、住院时间短等优点,但LC的严重并发症(出血、胆漏)仍时有发生。胆漏带给患者的不仅是疼痛,还能导致严重感染,脓肿形成,并发多器官功能衰竭,是具有潜在危及生命风险的并发症。LC术后胆漏也常是外科医疗纠纷产生的原因。胆漏一旦发生,都需要予以引流、内镜下支架置入、或是再次手术行胆道修复或胆道重建术。故熟悉可能导致胆漏的原因和胆漏的预防显得尤为重要。本文就近年的文献从解剖变异、急性或慢性炎症、胆囊管残端的处理方面对LC胆漏的原因进行了分析,并且从术前准备、手术技巧及术中特殊方法的应用方面对LC胆漏的预防进行了阐述,以期增强对LC胆漏的重视,减少LC胆漏的发生。
[Abstract]:Laparoscopic cholecystectomy (laparoscopic cholecystectomy, LC) is the smallest cholecystectomy at present. It has the advantages of small wound, small interference to the abdominal viscera, quick recovery and short hospitalization, but the severe complications of LC (bleeding, bile leakage) still occur. The bile leakage brings not only pain but also serious feeling to the patient. Infection, abscess formation, complicated with multiple organ failure, is the cause of biliary leakage after.LC operation, which is potentially life-threatening. Bile leakage is often caused by surgical disputes. If bile leakage occurs, it is necessary to drainage, endoscopic stent implantation, or reoperation of biliary tract repair or biliary reconstruction. The prevention of LC bile leakage is analyzed in recent years from the aspects of anatomical variation, acute or chronic inflammation, the treatment of the stump of the gallbladder, and the prevention of LC bile leakage from the preoperative preparation, surgical techniques and the application of special methods in the operation in order to enhance the bile leakage of LC. Attention should be paid to reduce the incidence of LC bile leakage.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R657.4

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