Causes and treatments of severe complications after laparoscopic surgery
10.3877/cma.j.issn.2095-3232.2015.01.008
- VernacularTitle:腹腔镜术后严重并发症的发生原因及处理
- Author:
Dong ZHAO
1
;
Hongchun LI
;
Nan LIN
;
Yanzhu LI
;
Hongguang TAO
;
Hua ZONG
;
Jie QIN
;
Fuyong QIAN
Author Information
1. 518000,深圳市第三人民医院普通外科 1
- Keywords:
Laparoscopes;
Postoperative complications;
Bile ducts,extrahepatic;
Intestinal obstruction;
Reoperation
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2015;(1):27-30
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the causes and treatments of severe complications after laparoscopic surgery. Methods Clinical data of 7 cases with severe complications after laparoscopic surgery in the Third People’s Hospital of Shenzhen from January 2008 to January 2013 were analyzed retrospectively. The informed consents of all patients were obtained and local ethical committee approval had been received. There were 3 males and 4 females with the age ranging from 6 to 67 years old and median of 40 years old. The diagnosis, treatments clinical data of the patients were collected, and the causes, treatments and prevention measures of the complications were summarized. Results Five cases underwent laparoscopic cholesystectomy (LC), 4 of which suffered bile duct injury for severe abdominal adhesion and unclear anatomy of the Calot triangle and 1 case suffered strangulated intestinal obstruction after operation because the hepatic falciform ligament was ruptured when puncturing below the xiphoid. One case underwent laparoscopic high ligation of hernial sac for indirect inguinal hernia and suffered strangulated intestinal obstruction after operation because part of the small intestine ran out of the peritoneum through the port site below the umbilicus. One case underwent laparoscopic tension-free repair for indirect inguinal hernia and suffered ischemic necrosis of the left testis possibly because of testicular torsion when stretching the tissue. The 4 cases with bile duct injury received primary drainage, 3 of which underwent secondary Roux-en-Y cholangiojejunostomy for severe biliary stricture and all recovered well after operation, and the other case underwent endoscopic biliary stent implantation 3 months after operation. The 2 cases with strangulated intestinal obstruction underwent emergent partial resection and end-to-end anastomosis of small intestine and recovered well after operation. The case with necrosis of testis underwent testicular excision. Conclusions The main causes of severe complications after laparoscopic surgery probably are the unclear local anatomy and failing to convert surgical procedure timely, etc. Early diagnosis, comprehensive evaluation and proper surgical interventions are the important measures for improving the prognosis of these patients.
