摘要
目的总结肝硬化胆囊切除的危险性及经验教训。方法对40例肝硬化胆囊切除手术患者的临床资料进行了回顾性分析。结果38例完成了胆囊切除手术。术中胆囊床破裂大出血4例,胆囊床广泛渗血11例;此15例应用带蒂大网膜填塞胆囊床止血术成功,术后未再出血。术中出血量平均400mL,最多1例>10000mL。6例术后出现腹水。无胆道损伤。无死亡病例。平均住院15d。结论术中出血和胆道损伤是肝硬化胆囊切除的主要危险;带蒂大网膜填塞胆囊床止血法是较好的止血方法。
Objective To evaluate the dangerous and experience of cholecystectomy in patients with liver cirrhosis. Methods The clinical data of 40 patients with liver cirrhosis undergoing cholecystectomy were retrospectively analyzed. Results Cholecystectomy was successfully performed in 38 patients. [ntraoperative rupture of gallbladder bed with severe hemorrhage occurred in 4 cases, and extensive oozing of blood from gallbladder bed in 11 cases. In those 15 cases , the gallbladder bed was packed with omental pedicle , the bleeding was successfully controlled in all of the 15 cases, and with no rebleeding postoperatively. Intraoperative blood loss avcraged 400mL, but 1 case had the maximum blood loss which was 〉 10 000mL. Six cases developed ascites postoperatively. There was no mortality or bile duct injury. The average hospital stay was 15d. Conclusions Intraoperative bleeding and bile duct injuries are the major dangers of cholecystectomy in patients with liver cirrhosis , and packing of gallbladder bed with pedicle of greater omentum is a satisfactory method of hemostasis.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第8期582-584,共3页
China Journal of General Surgery
