腹腔镜胆囊切除术后外科黄疸(附16例分析)

Surgical jaundice after laparoscopic cholecystectomy:Analysis of 16 cases

目的 探讨腹腔镜胆囊切除术 (laparoscopiccholecystectomy ,LC)后外科黄疸的原因、治疗及预防措施。 方法对我院 1994年 1月～ 2 0 0 2年 1月 30 92例LC中 14例外科黄疸及外院转入 2例共 16例进行回顾性分析。 结果 16例中 9例胆石残留 ,7例胆管损伤 ,包括 2例胆囊管漏 ,3例胆 (肝 )总管损伤 ,2例迷走胆管漏后二次黄疸。 16例均经手术治愈 ,无胆道狭窄发生。 结论 减少LC术后外科黄疸的关键在于掌握好LC的手术适应证 ,规范手术操作 。

Objective To discuss the causes,treatment and prophylaxis of surgical jaundice after laparoscopic cholecystectomy (LC). Methods A retrospective analysis was carried out in 16 cases of surgical jaundice consisting of 14 cases from this hospital out of 3 092 cases of LC from January 1994 to January 2002 and 2 cases transferred from other hospitals. Results Out of the 16 cases,residual bile duct stones were found in 9 cases,and bile duct injuries had taken place in 7 cases (2 cases of cystic duct stump leakage,3 cases of common bile/hepatic duct injuries and 2 cases of recurrent jaundice resulted from aberrant bile duct leakage).All the 16 cases were cured by surgery and no bile duct stricture occurred after surgical procedures. Conclusions Strict following indications of LC and normative surgical performance are the keys to the decrease of surgical jaundice after LC.The patient should be given active surgical intervention once surgical jaundice occurs.