Causes and Treatment of Digestive Tract Injury during Laparoscopic Cholecystectomy / 中国微创外科杂志

ABSTRACT

Objective To investigate the causes,preventive measures and treatment of digestive tract injury during laparoscopic cholecystectomy (LC). Methods From January 2000 to December 2007,totally 21 640 patients underwent LC in our hospital,among them,16 had digestive tract injury including injuries in the stomach and duodenum in 14 patients,in the colon in 1,and in the ileum in 1. Results Among the 16 cases,13 were detected during the operation,and thus laparoscopic repair were performed on 3 of the cases,and conversion to open surgery were carried out for the other 10 for repair of the injured tract (7 cases) or major resection of the stomach and Roux-en-Y anastomosis (3 cases). The other 3 patients were confirmed after LC;they received open surgery for repair of the ileum,colostomy or intra-abdominal cavity drainage. In the 16 cases,one patient died of duodenal leakage complicated with multiple organ dysfunction syndrome in 7 days after the operation;the other 15 patients were cured and discharged from hospital without severe complications. Conclusions Most of the digestive tract injury cases during LC are caused by pericholecystic inflammatory adhesion,which leads to insufficient exposure of the surgical field resulting in the tear or perforation of the digestive tract. Proper treatment in early stage is the key to the prognosis of the patients and prevention of severe complications.