腹腔镜胆囊切除术中胆管损伤的预防

Avoidance of Bile Duct Injury During Laparoscopic Cholecystectomy

本组腹腔镜胆囊切除术３００例，术中胆总管损伤２例（０．６７％）．及时中转开腹手术一期修复；术后肝床胆漏肝下包裹性积液１例（０．３３％），经穿刺置管引流治愈。本组无手术死亡及２次手术。本文讨论了腹腔镜胆囊切除术中预防胆道损伤的几项措施，如手术适应证的掌握，术中牵引、分离胆囊的方法及困难病例的处理等。

cases of laparcopic cholecystectomy were reporied. Among them,2 common bile ducts were injured(0.67%)during the surgery,and were repaired by changing to the open surgery.1 case(0.33%)had a postoperative bile leak from bladder bed, and curred by draining.There were not any death and any seconary surgery in our group. Someproblems about avoidance of bile duct during laparoscopic cholecystectomy were discussed in the article, such as:the indication, the retraction and disection,and the treatment of puzzled cases.