[腹腔镜胆囊切除术并发症]。

G.E.N Pub Date : 1994-10-01
C Tombazzi, B Lander, R Bacalao, D Marquez, V Lecuna
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引用次数: 0

摘要

腹腔镜胆囊切除术是1987年描述的一种外科手术,它有一个重要的最高点它可以替代开腹手术。其优点之间是显著的,术后进化无疼痛,麻痹性肠梗阻,住院时间短,除此之外,患者在某些情况下可当日出院。在委内瑞拉,这种手术受到了外科医生的热情欢迎,他们更喜欢这种手术。然而,在第一次手术中,由于缺乏经验,出现了一些并发症,但这些并发症的发生与经验无关。由于各种原因,复杂性的量化并不容易实现。我们报告了12例并发症,其中2例属于在加拉加斯大学医院干预的患者,10例属于从其他中心转移的患者。并发症有:肝动脉假性动脉瘤、肝壁血肿、胆总管切开、右侧胆管切断术、囊床脓肿2例、肾后气腹、胆道瘘腹水、胆囊瘤4例。治疗方法各不相同,其中5例采用经皮引流的放射技术。我们得出结论:首先,该技术并非没有并发症。其次,经皮引流(脓肿、胆囊瘤)、瘘管内窥镜手术(胆道假体)和动脉造影(动脉栓塞)在某些情况下是有用的,可以防止手术再干预。
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[Complications of laparoscopic cholecystectomy].

The laparoscopy cholecistectomy is a surgical procedure described in 1987, and it has had an important apogee and it's had substitute to open procedure. Between its advantages is notable, the postoperatory evolution without pain, paralytic ileus and the short time of hospitalization besides the patient can go away the same day in some cases. In Venezuela, the procedure has been received with enthusiasm by the surgeons with prefer this procedure however, there are complications derived in part for the lack of experience in the first cases, but occur non related of the experience. The quantization of the complications is not simple to realize for different reasons. We present twelve complications, two belong to patients intervened in the Hospital Universitario de Caracas and ten belong to patient transferred from other center. The complications were: pseudoaneurism of hepatic artery, hematoma of the wall, cutting of common bile duct, section the right bile duct, abscess of vesicular bed in two cases, retropneumoperitoneum, ascites by biliary fistula and four biloma. The treatment varied in every case and the utilization of radiologic technique with percutaneous drainage were useful in five cases. We conclude: first, this technique is not free of complications. Second, the percutaneous drainage (abscess, biloma), endoscopic procedure (biliary prosthesis) in fistulaes and arteriographics (arterial embolization), are useful in some cases, and could prevent the surgical reintervention.

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