胆囊管逆行分离法在1460例腹腔镜胆囊切除术中的应用

Application of retrograde dissection of the cystic duct in 1 460 cases of laparoscopic cholecystectomy

目的探讨腹腔镜下安全、有效的解剖胆囊管的方法。方法2002年12月～2005年12月，我院采用胆囊管逆行分离法解剖胆囊管行1460例腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）。结果顺利完成LC 1442例，手术时间15～100min，平均42min。中转开腹18例（1．23％），胆管损伤5例（0．34％），腹腔出血3例（0．21％），胆漏3例（0．21％）。随访2～24个月，平均11．8月，胆总管残余结石2例。结论胆囊管逆行分离法解剖胆囊管行LC是一种安全、容易掌握的手术方法。

Objective To study a safe and effective method for the dissection of the cystic duct under laparoscope. Methods Laparoscopic cholecystectomy was performed in 1 460 cases, by using the retrograde dissection of the cystic duct, from December 2002 to December 2005 in this hospital. Results The laparoscopic cholecystectomy was successfully completed in 1 442 cases, with an operation time of 15～100 min （mean, 42 min）. A conversion to open surgery was required in 18 cases （1.23%）. Complications included 5 cases of bile duct injury （0.34%）, 3 cases of intrasbdominal hemorrhage （0.21%）, and 3 cases of biliary leakage （0.21%）. Follow-up for 2～24 months （mean, 11.8 months） found 2 cases of residual calculi in the common bile duct. Conclusions The retrograde dissection of the cystic duct during laparoscopic cholecystectomy is a safe method and simple to perform.