【Abstract】Objective To investigate prophylactic measures for nontraumatic complications of laparoscopic cholecystectomy (LC).Methods The data of 13 000 patients who underwent LC in Kunming general hospital of PLA over 13 years(1991-2004) were retrospectively reviewed. Results Nine malignant tumors and 47 common bile duct stones were missed at LC. The 9 malignant tumors included hepatic cancer (n=1), gastric cancer (n=1), gallbladder cancer (n=2), pancreatic cancer (n=2) and right colon cancer (n=3). Of all the carcinomas, 3 patients with right colon cancer underwent colectomy, the other 6 patients couldn’t be cured radically. All the 47 patients with choledocholithiasis were cured successfully, among them 31 patients were performed with ERCP and 16 were reoperated on with cholangiotomy. Conclusion This study emphasizes the necessity to analyze carefully patients’ symptoms before operation and pay attention to pathological changes of gallbladder and intraabdominal situation intraoperatively. If necessary, laparoscopic ultrosonography can be used to avoid missing malignant tumors and biliary stones.
Citation：
ZHANG Jixiang,CHEN Xunru,LUO Ding,MAO Jingxi,ZHOU Zhengdong,YU Shaoming,LI Shenghong,LIU Cheng,HAN Jiang,LI Linhai,WANG Hongguang,JIN Yun,QING Deke,CHEN Gang.. Prophylactic Measures for Non
Traumatic Complications of Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(6): 558-560. doi:
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Copyright ? the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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張吉祥，陳訓如，羅丁. 腹腔鏡膽囊切除術中膽道外腹腔內病變遺漏的防范 [Ｊ]. 中國微創外科雜志， 2004； 4（1） 812 陳訓如，田伏洲，黃大熔主編. 微創膽道外科手術學 [M].第1版.北京： 軍事醫學科學出版社， 2000117~1183 Kingham JG, Dawson AM. Origin of chronic right upper quadrant pain [Ｊ]. Gut, 1985; 26(8)7834 Soper NJ, Stockmann PT, Dunnegan DL, et al. Laparoscopic cholecystectomy. The new ‘gold standard’? [Ｊ]. Arch Surg, 1992; 127(8)9175 Shirai Y, Yoshida K, Tsukada K, et al. Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy [Ｊ]. Ann Surg, 1992; 215(4)3266 Paolucci V, Schaeff B, Schneider M, et al. Tumor seeding following laparoscopy: international survey [Ｊ]. World J Surg, 1999; 23(10)9897 劉國禮. 我國腹腔鏡外科的現狀——156 820例腹腔鏡手術綜合報告 [Ｊ]. 中華普通外科雜志， 2001； 16（9）5628 Berdah SV, Orsoni P, Bege T, et al. Followup of selective endoscopic ultrasonography and/or endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy: a prospective study of 300 patients [Ｊ]. Endoscopy, 2001; 33(3)2169 田伯樂，張肇達，胡偉明，等. 無癥狀性膽總管結石的診治經驗 [Ｊ]. 肝膽外科雜志， 1999； 7（4）27310 王宏光，陳訓如. LC與膽總管結石的治療策略 [Ｊ]. 中華肝膽外科雜志， 2004； 10（2）14211 張吉祥，陳訓如，羅丁. 腹腔鏡膽囊切除術立即中轉開腹37例分析 [Ｊ]. 臨床外科雜志， 2004； 12（6）38012 羅丁著. 腹腔鏡超聲診斷學 [M]. 第1版. 北京： 軍事醫學科學出版社， 200349~5113 李勝宏，陳訓如，羅丁，等. 腹腔鏡膽囊切除術殘留膽管結石的防治 [Ｊ]. 中華臨床醫學雜志， 2003； 4（21）5514 Ammori BJ, Birbas K, Davides D, et al. Routine vs “on demand” postoperative ERCP for small bile duct calculi detected at intraoperative cholangiography. Clinical evaluation and cost analysis [Ｊ]. Surg Endosc, 2000; 14(12)1123.
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張吉祥，陳訓如，羅丁. 腹腔鏡膽囊切除術中膽道外腹腔內病變遺漏的防范 [Ｊ]. 中國微創外科雜志， 2004； 4（1） 812 陳訓如，田伏洲，黃大熔主編. 微創膽道外科手術學 [M].第1版.北京： 軍事醫學科學出版社， 2000117~1183 Kingham JG, Dawson AM. Origin of chronic right upper quadrant pain [Ｊ]. Gut, 1985; 26(8)7834 Soper NJ, Stockmann PT, Dunnegan DL, et al. Laparoscopic cholecystectomy. The new ‘gold standard’? [Ｊ]. Arch Surg, 1992; 127(8)9175 Shirai Y, Yoshida K, Tsukada K, et al. Inapparent carcinoma of the gallbladder. An appraisal of a radical second operation after simple cholecystectomy [Ｊ]. Ann Surg, 1992; 215(4)3266 Paolucci V, Schaeff B, Schneider M, et al. Tumor seeding following laparoscopy: international survey [Ｊ]. World J Surg, 1999; 23(10)9897 劉國禮. 我國腹腔鏡外科的現狀——156 820例腹腔鏡手術綜合報告 [Ｊ]. 中華普通外科雜志， 2001； 16（9）5628 Berdah SV, Orsoni P, Bege T, et al. Followup of selective endoscopic ultrasonography and/or endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy: a prospective study of 300 patients [Ｊ]. Endoscopy, 2001; 33(3)2169 田伯樂，張肇達，胡偉明，等. 無癥狀性膽總管結石的診治經驗 [Ｊ]. 肝膽外科雜志， 1999； 7（4）27310 王宏光，陳訓如. LC與膽總管結石的治療策略 [Ｊ]. 中華肝膽外科雜志， 2004； 10（2）14211 張吉祥，陳訓如，羅丁. 腹腔鏡膽囊切除術立即中轉開腹37例分析 [Ｊ]. 臨床外科雜志， 2004； 12（6）38012 羅丁著. 腹腔鏡超聲診斷學 [M]. 第1版. 北京： 軍事醫學科學出版社， 200349~5113 李勝宏，陳訓如，羅丁，等. 腹腔鏡膽囊切除術殘留膽管結石的防治 [Ｊ]. 中華臨床醫學雜志， 2003； 4（21）5514 Ammori BJ, Birbas K, Davides D, et al. Routine vs “on demand” postoperative ERCP for small bile duct calculi detected at intraoperative cholangiography. Clinical evaluation and cost analysis [Ｊ]. Surg Endosc, 2000; 14(12)1123.
