腹腔镜胆囊切除术后胆漏的原因分析

The management for bile leakage after laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后胆漏的原因及防治方法。方法总结LC后并发8例胆漏的诊治经验。结果 LC后8例胆漏病例中肝外胆道损伤2例,肝总管壁电凝烧灼伤1例,胆囊床毛细胆管渗漏3例,迷走胆管漏1例,胆囊管钛夹脱落1例。均经相应治疗痊愈出院。结论肝外胆管、迷走胆管损伤及胆囊管残端钛夹脱落是腹腔镜胆囊切除术后胆漏的主要原因,建立通畅的腹腔引流,行胆总管修补、T管支持引流或胆肠吻合是治疗腹腔镜胆囊切除术后胆漏、预防并发症出现的主要方法。

Objective To investigate the cause for bile leakage after laparoscopic cholecystectomy (LC) .Methods To summarize the experiment of 8 bile leakage cas LC procedure. Results Post operation,2 cases among them for injury of bile duct outside liver,1 case for heated injury,3 for leakage of cholangiole,1 for injury of aberrant duct ,1 for clip exfoliation . All cases have been cured. Conclusion Bile duct injury is the most common cause of bile leakage after LC. Patent drainage,bile duct repair and T tube stenting or choledochojejunostomy are the main method in treating bile leakage after LC.