Die iatrogene Dünndarmperforation als Komplikation der laparoskopischen Cholezystektomie

Zusammenfassung

Nach 1 125 laparoskopischen Cholezystektomien berichten wir über den seltenen Fall einer perioperativen Dünndarmläsion. Die Symptomatik begann akut am 3. postoperativen Tag mit Bauchschmerzen. Über die noch liegende Robinsondränage entleerte sich wenig später Dünndarminhalt. Bei der Laparotomie zeigte sich eine 4 mm große Perforationsstelle des terminalen Ileum. Sie wurde exzidiert und zweireihig vernäht. Der weitere postoperative Verlauf war unkompliziert. Die Ursache der Perforation konnte nicht geklärt werden; mögliche Ursachen werden diskutiert.

Abstract

Having done 1 125 laparoscopic cholecystectomies we want to report an exceptional case of perioperative bowel lesion. The symptoms began with abdominal pain on the third postoperative day, followed by an evacuation of intestinal contents out of the Robinson-Drainage. The laparotomy showed a 4 mm lesion of the terminal ileum, which could be excised and closed. Any other complications were not recognized. The reason that caused the perforation could not be clarified. Possible mechanisms will be discussed.

Schlüsselwörter

Laparoskopische Cholezystektomie - Dünndarmperforation - MIC - Komplikationen

Key words

Laparoscopic cholecystectomy - Small bowel perforation - Minimal invasive surgery - Complications

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