摘要
目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)致胆管损伤的手术时机、手术方式和技巧。方法回顾12例LC后胆管损伤病例,术中发现2例,术后发现10例。胆囊床小胆管损伤1例,胆囊管残端胆漏1例,肝总管胆总管侧壁撕裂、部分剪断9例,肝总管离断1例。结果本组1例术中胆总管侧壁撕裂损伤,经中转开腹行胆总管修补和T管引流而治愈;术后2例出现胆漏,经充分引流后自愈;1例术后2 d行胆总管修补T管引流者术后发生胆管狭窄及胆道炎症,于1年后行胆管空肠Roux-en-Y吻合术后治愈;其余8例均经胆肠吻合术治愈。随访1.5~5年,无胆道狭窄及胆管炎发作。结论手术仍是LC致胆管损伤的首选治疗方法。把握手术时机避免盲目自信,及早选择有经验的专科医生恰当处理是提高治愈率的关键。
Objective To investigate the experiences of the re-operative treatment for bile duct injury(BDI) during laparoscopic cholecystectomy(LC). Method 12 cases suffered from BDI were retrospectively analyzed,among whom 1 case with tiny bile duct injury,1 case with cystic duct stump leakage,9 cases of common bile duct or common hepatic duct injury and 1 cases of transection of common hepatic duct. Results One patient was successfully undergone primary common bile duct repair and T-tube drainage by conversion to op...
出处
《中国现代手术学杂志》
2009年第4期267-269,共3页
Chinese Journal of Modern Operative Surgery
关键词
胆囊切除术
腹腔镜
胆道
创伤和损伤
再手术
cholecystectomy
laparoscopic
bile tract
wounds and injuries
reoperation
