探讨腹腔镜胆囊切除术（LC）后严重并发症的处理方法。

回顾性分析2012年9月至2017年11月开滦总医院收治的22例LC术后严重并发症患者临床资料。其中男8例，女14例；年龄47～88岁，中位年龄59岁。患者均签署知情同意书，符合医学伦理学规定。总结分析患者术后严重并发症的处理方法。

3例术后出血，其中1例肝动脉损伤急诊开腹止血，2例胆囊动脉出血行介入栓塞治疗。6例胆漏，其中3例放置腹腔引流管，给予制动、禁饮食、抗炎、补液对症处理；急诊开腹引流2例，超声引导下穿刺引流1例。7例胆管损伤，其中放置腹腔引流管1例，开腹放置T管4例，行胆肠Roux-en-Y吻合1例，胆总管修补术1例。6例术后胆总管结石，其中中西医结合治疗1例，再次经腹腔镜手术治疗2例，ERCP检查取石3例。经积极恰当处理，患者均获痊愈。

术前详细询问病史，术中熟悉解剖关系，选择恰当开腹时机，维护正常生理通道是LC术后发生严重并发症患者良好预后的关键。

To explore the treatments of severe complications after laparoscopic cholecystectomy (LC).

Clinical data of 22 patients with severe complications after LC admitted to Kailuan General Hospital from September 2012 to November 2017 were retrospectively analyzed. Among them, 8 patients were male and 14 female, aged 47-88 years with a median age of 59 years. The informed consents of all patients were obtained and the local ethical committee approval was received. The treatments of severe postoperative complications were summarized and analyzed.

3 cases suffered from hemorrhage after operation, 1 of them treated with emergent open hemostasis due to hepatic artery injury and 2 cases of gallbladder artery hemorrhage received interventional embolization. 6 cases developed bile leakage, 3 of them had abdominal drainage tube placed and received symptomatic treatments, such as immobilization, fasting and water deprivation, anti-inflammatory, and fluid infusion, 2 cases received emergent open drainage and 1 case underwent ultrasound-guided puncture drainage. 7 cases suffered from bile duct injury,1 of them had abdominal drainage tube placed, 4 cases had T tube placed through open surgery, 1 case underwent Roux-en-Y anastomosis and 1 case underwent repair of common bile duct. 6 cases suffered from postoperative choledocholithiasis. Among them, 1 case was treated with integrated therapy of traditional Chinese and western medicine, 2 cases underwent repeated laparoscopic surgery and 3 cases were treated with ERCP. After active and appropriate treatments, all patients were cured.

Explicit preoperative inquiry of medical history, well knowing the anatomical relations during operation, selecting the appropriate timing of open surgery and protecting the normal physiological channels are the key factors for well prognosis of patients with severe complications after LC.