Najczęstsze powikłania chirurgii małoinwazyjnej
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Najczęstsze powikłania chirurgii małoinwazyjnej

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Pomimo korzyści, jakie niewątpliwie niesie za sobą rozwój chirurgii małoinwazyjnej, wideochirurgia może powodować również różnego rodzaju powikłania śródoperacyjne oraz następstwa operacyjne. Przeczytaj, które z nich są najbardziej niebezpieczne.

Powikłania po zabiegach chirurgii małoinwazyjnej zależą przede wszystkim od rodzaju wideoskopowych zabiegów operacyjnych. Wśród nich wyróżnia się zabiegi resekcyjne w obrębie górnego i dolnego odcinka przewodu pokarmowego, zabiegi antyrefluksowe, zabiegi na drogach żółciowych czy zabiegi przepuklin brzusznych.

Cholecystektomia, czyli laparoskopowe wycięcie pęcherzyka żółciowego to tzw. „złoty standard” w leczeniu objawowej kamicy żółciowej. Do najczęstszych powikłań tego zabiegu zalicza się:

  • Wytworzenie odmy otrzewnowej (uszkodzenie „rury” przewodu pokarmowego, dużych naczyń),
  • Powikłania związane z wprowadzeniem trokarów (uszkodzenie rury przewodu pokarmowego, dużych naczyń, krwawienia z powłok),
  • Powikłania i trudności śródoperacyjne, które mają związek z zasadniczym etapem operacji (uszkodzenie dróg żółciowych, uszkodzenie naczyń, przepony, wątroby, przewodu pokarmowego),
  • Powikłania pooperacyjne, które wymagają reoperacji, takie jak: krwawienie do jamy otrzewnej, z przewodu pokarmowego, uszkodzenie dróg żółciowych, niedrożność jelit, ropień).

Najbardziej niebezpiecznymi powikłaniami są uszkodzenie dużych naczyń, uszkodzenie dróg żółciowych, uszkodzenie przewodu pokarmowego, inne krwawienia np. z obszaru operowanego czy przewodu pokarmowego, jak również choroba zakrzepowo-zatorowa.

Reoperacji będą wymagały takie powikłania, jak krwawienie z loży po pęcherzyku żółciowym, punktowe przedziurawienie przewodu żółciowego wspólnego, punktowe przedziurawienie dwunastnicy, przedziurawienie ściany jelita cienkiego, zsunięcie się klipsa z przewodu pęcherzykowego, wyciek żółci z przewodu pęcherzykowego poniżej założonych klipsów, a także krwiak podtorebkowy wątroby.

Źródło: Głuszek S., Chirurgia podstawy, Wydanie II uaktualnione i rozszerzone Warszawa 2019, s. 389

Przeczytaj także: Jak odróżnić odleżynę od zapalenia skóry związanego z nietrzymaniem moczu? 3 ważne zasady

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