摘要
作者对在过去１年中所完成的１７８例腹腔镜胆囊切除术胆囊床的情况进行了分析。按术中胆床裸露肝组织的范围，将胆床损伤分为３度：Ⅰ度４９例，无肝组织裸露，胆床纤维膜完整；Ⅱ度９０例，裸露肝组织小于１／２胆床面；Ⅲ度３９例，裸露肝组织大于１／２胆床面。作者认为：胆床损伤分度与腹腔镜胆囊切除术能否顺利进行及术后并发症关系密切，并发症预防的关键是保留完整的胆床纤维膜，胆床伤在Ⅲ度或Ⅱ度伴有深的裸露肝组织时，应置肝下引流。
Injury of the gallbladder beds on the liver during laparoscopic cholecystectomy of 178 cases for the last year was analysed. Reoperations in 6 cases with one death due to major postoperative complications. These injuries could be classified into 3 degrees according to extent of liver parenchyma denuded in the bed. Degree Ⅰ, no liver was denuded in the bed with the fibromembranous lining intact (49 cases); Degree Ⅱ, liver denuded area was less than one half of the bed (90 cases); Degree Ⅲ, liver denuded area was greater than half of the bed (39 cases). There was close relationship between grade of the bed injury and the postoperative complication. Leaving the lining intact of the bed was most important during the laparoscopic cholecystectomy in order to prevent complication from the bed. The method was discussed. Drainage of the subhapatic space was suggested when liver bed is denuded.
