微创保胆取石(息肉)术中胆囊内出血的处理技巧
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Means of haemostasis in gallbladder preserving cholecystolithotomy
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    目的 探讨腹腔镜保胆取石(息肉)术中胆囊内出血的止血技术。方法 回顾分析笔者实施腹腔镜保胆取石(息肉)术512例中,出现术中胆囊内出血31例,使用压迫止血、副肾冷盐水灌洗、高频电电凝止血和囊壁可吸收线缝合等综合措施情况,分析处理的安全性及有效性。结果 31例患者中:全部得到满意止血,无1例中转切除胆囊,无1例胆囊穿孔或术后胆漏,压迫灌洗法满意率不高,控制性电凝止血满意率28/29(96.6%),不能满意止血的1例,胆囊外“8字”缝合一针成功止血。结论 控制性电凝止血法安全高效,应为首选止血方法,但压迫灌洗法是基础,胆囊壁缝合法是其补充。

    Abstract:

    Objective?To explore the means of haemostasis in gallbladder preserving cholecystolithotomy. Methods The clinical data of 31 cases were retrospectively analyzed, summarizes the successful experiences. Results There appeared 31 cases the gallbladder internal bleeding in 512 cases gallbladder preserving cholecystolithotomy. In all the cases, 31 operations were stopped bleeding satisfactorily and performed successfully without conversion to conventional laparoscopic surgery, without perforation of gallbladder. pressure and lavage hemostasis had common effect, the control coagulation hemostasis had satisfaction rate 96.6%. Except one patient used gallbladder whole layers suture method. Conclusion The control coagulation hemostasis with the high-frequency electric knife is the optimal way, pressure and lavage hemostasis is basal, and gallbladder whole layers suture method is supplement.

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廖霄斌,王国良,赵方,杨世雄.微创保胆取石(息肉)术中胆囊内出血的处理技巧[J].中国内镜杂志,2016,22(9):105-107

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  • 收稿日期:2016-04-21
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  • 在线发布日期: 2016-09-30
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