腹腔镜胆囊切除术胆道损伤的预防

Prevention of trauma of biliary tract in laparoscopic cholecystectomy

目的探讨如何预防腹腔镜胆囊切除术中胆道损伤。方法回顾分析1999年10月～2004年10月502例腹腔镜胆囊切除术的临床资料。结果18例因胆囊Calot蒺s三角严重粘连、胆囊严重萎缩或既往有上腹部手术史,致使局部紧密粘连者中转开腹,502例中1例胆道损伤。术后2～5天(平均3天)出院。结论腹腔镜胆囊切除术应严格选择病例,仔细处理Calot's三角,使用超声刀分离,适时中转开腹手术是预防胆管损伤的重要措施。

Objective To investigate the prcvention of trauma of biliary tract during laparoscopic cholecystectomy.Methods From October 1999 to October 2004,the clinical data of 502 cases received laparoscopic cholecystectomy were analyzed restrospectively.Results Among 502 cases,LC was performed smoothly in 483 cases,18 cases were transferred to open cholecystectomy because of severe adhesion of Calot＇s triangle,severe atrophy of gall bladder or past history of epigastric operation.The biliary tract was impaired in 1 case.Conclusion The case should be selected strictly for laparoscopic cholecystectomy.Careful dissecting the Calot＇s triangle and timely transferring open cholecystectomy are important measure to prevent the trauma of biliary tract.