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首页> 外文期刊>Surgical Endoscopy >Complications due to gallstones lost during laparoscopic cholecystectomy.
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Complications due to gallstones lost during laparoscopic cholecystectomy.

机译：由于腹腔镜胆囊切除术中胆结石丢失而引起的并发症。

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摘要

BACKGROUND: The aim of this study was to identify predisposing factors for complications after gallstone spillage during laparoscopic cholecystectomy (LC). METHODS: Papers derived from Medline search and papers from reference lists within these papers were studied. Ninety-one reports on complications caused by lost gallstones published between 1991 and 1998 were analyzed. These patients were compared with cases in published series on LC in general. RESULTS: Gallbladder perforation (20%) and stone spillage (9%) were the two most common complications of LC which occurred during the dissection (75%) and removal (25%) of the gallbladder. Predisposing factors for developing complications after stone spillage were: older age, male sex, acute cholecystitis, spillage of pigment stones, number of stones (>15) or size of the stone (O > 1.5 cm), and perihepatic localization of lost stones. CT-scan and ultrasound examination proved best for the recognition of complications caused by lost stones. Explorative laparotomy and surgical removal of the stones was the most frequently used therapy. CONCLUSIONS: Gallbladder perforation and stone spillage might cause hazardous complications. In cases with loss of numerous or large pigment stones which cannot be retrieved by laparoscopy, intraoperative conversion to open surgery can be justified.
机译：背景：本研究的目的是确定腹腔镜胆囊切除术（LC）胆石溢漏后并发症的诱因。方法：研究了从Medline搜索获得的论文以及这些论文中的参考文献列表中的论文。分析了1991年至1998年间发表的关于胆结石丢失引起的并发症的九十一份报告。通常将这些患者与已发表的有关LC的系列患者进行比较。结果：胆囊穿孔（20％）和结石漏出（9％）是LC最常见的两种并发症，发生在胆囊切除术（75％）和切除胆囊（25％）期间。结石溢出后发生并发症的诱发因素有：年龄较大，男性，急性胆囊炎，色素结石溢出，结石数目（> 15）或结石大小（O> 1.5 cm）以及肝丢失的结石在肝内的位置。事实证明，CT扫描和超声检查最适合识别结石丢失引起的并发症。探索性剖腹手术和手术切除结石是最常用的疗法。结论：胆囊穿孔和结石溢出可能导致危险的并发症。如果丢失大量或大块无法通过腹腔镜检查恢复的色素结石，则可以证明术中转为开腹手术是合理的。

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