CAJ | 학술논문

目的：探讨腹腔镜胆囊切除(LC)后黄疸的原因、预防措施及处理方法。方法回顾分析性本院4362例LC后发生黄疸的36例临床资料并结合文献进行总结。结果内科性黄疸16例，梗阻性黄疸20例(包括胆道损伤7例，胆总管结石9例，胆道蛔虫2例，原因不明2例）。开腹手术中1例患者继发腹腔脓肿转上级医院治疗，其余治愈。结论LC后黄疸与许多因素有关，十分复杂，我们必须详细全面的检查以明确诊断，区分梗阻性黄疸与内科性黄疸。梗阻性黄疸以胆管损伤和胆道结石为主要原因，内科性黄疸与术前患者的肝功能状况、中气腹压力大小、手术时间长短密切相关，当诊断不明确时，处理应更为谨慎，强调对发生黄疸病例的处理采用个体化原则。
목적：탐토복강경담낭절제(LC)후황달적원인、예방조시급처리방법。방법회고분석성본원4362례LC후발생황달적36례림상자료병결합문헌진행총결。결과내과성황달16례，경조성황달20례(포괄담도손상7례，담총관결석9례，담도회충2례，원인불명2례）。개복수술중1례환자계발복강농종전상급의원치료，기여치유。결론LC후황달여허다인소유관，십분복잡，아문필수상세전면적검사이명학진단，구분경조성황달여내과성황달。경조성황달이담관손상화담도결석위주요원인，내과성황달여술전환자적간공능상황、중기복압력대소、수술시간장단밀절상관，당진단불명학시，처리응경위근신，강조대발생황달병례적처리채용개체화원칙。
Objective To summarize the reasons and treatmen ts of jaundice after LC.Methods??After?review?analytical?this?courtyard?4362?example?LC?has?the?jaundice?36?example?clinical?material?and?unifies?the?literature?to?carry?on?the?summary.?Results??The?internal?medicine?department?jaundice?16?examples,?the?obstruction?jaundice?20?examples?(damage?7?examples?including?biliary?duct,?choledoch?stone?9?examples,?biliary?duct?roundworm?2?examples,?reason?unclear?2?examples).In?36?examples?opens?abdomen?surgery?1?to?continue?sends?the?abdominal?cavity?abscess?to?transfer?the?higher?authority?hospital?treatment,?other?cure.?Conclusion??After?LC?jaundice?associated?with?many?factors,?very?complex,?we?have?a?detailed?and?comprehensive?checks?to?a?definitive?diagnosis,?the?distinction?between?obstructive?jaundice?and?jaundice?of?internal?medicine.?Obstructive?jaundice?and?biliary?calculus?of?bile?duct?injury?as?the?main?reason,?internal?preoperative?liver?function?status?in?patients?with?jaundice,?pneumoperitoneal pressure closely related to size, length of operation, when the diagnosis is not clear, its treatment should be more cautious, emphasizing the principles of handling individual cases of jaundice occurs.