Objective To discuss the pathogeny， treatment and prophylactic measures of postcholecystectomy syndrome (PCS). Methods The clinical data of 150 patients with laparoscopic PCS in our department from October 2000 to March 2009 were analyzed. Results Etiological factors were found in 131 patients: one hundred and twelve cases were due to the reasons of biliary system, including bile duct residual stones after cystic resection， the injury bile duct stenosis， a long residual cystic canal， nipple benign stricture, bile duct tumor etc; Nineteen examples were due to other reasons, including gallbladder stone merger reflux gastritis, gastroduodenal ulcer， diverticulum beside duodenal nipple, and so on, which resulted in the symptoms un-release after cystic resection. Nineteen cases were not found organic lesion. In ones whose etiological factors were definite, 117 cases were treated with different surgeries according to different etiological factors; another 33 cases were treated with conservative treatment. Total 145 cases were followed up, and 139 cases in them were cured or relieved at different degrees. Conclusion Careful preoperative examination, normalized operation avoiding damaging bile duct and leaving behind bile duct stones can effectively prevent laparoscopic PCS.
目的觀察持續沖洗負壓引流技術在腹部外科應用的臨床效果。方法回顧性分析2006年1月至2011年3月期間我院將自制雙套管實施持續沖洗負壓引流技術應用于172例腹部外科患者的臨床資料。結果全部患者的消化道瘺均治愈，瘺道愈合的平均時間為36 d。治療過程中，1例患者出現上消化道出血，另1例出現腹腔出血，無腹腔感染、皮膚破潰感染、膿毒癥等并發癥。結論采用持續沖洗負壓引流的雙套管制作簡單，經濟有效，在腹部外科中對術后腸瘺、出血、膽汁漏及感染的防治具有重要臨床意義。