改良法腹腔镜胆囊切除术在预防肝外胆管损伤中的作用(附254例报告)

Improved method to prevent extrahepatic bile duct injury in laparoscopic cholecystectomy:with a report of 254 cases

目的:评价改良法腹腔镜胆囊切除术(LC)在预防肝外胆管损伤中的作用。方法:254例胆囊良性疾病全部采用安全线外Calot's三角后外侧入路的改良法显露“三管一孔一脏器”行LC。术前均不置胃、尿管,无需术中冲洗,据需要放置引流管。结果:全部病例均成功采用改良法LC完成,术后平均住院3d,7例置引流管。无胆漏、肝外胆管损伤或死亡病例,术后1月B超复查正常。结论:采用改良法LC能有效预防肝外胆管损伤。

Objective：To evaluate the value of the improved method in preventing extrahepatic bile duct injury in laparoscopic cholecystectomy（LC）. Methods： Two hundred and fifty-four patients with benign diseases of gallbladder were adopted the improved method, exposing＂ three-duct, one-hole and one-organ＂ through posterior lateral portion of Calot＇s triangle begond the safe-line in LC. All the patients did not need preoperative gastric canal and urinary canal insertion and interoperative washing. Drainage tube was placed according to the condition. Results ： All patients were performed LC successfully with the improved method without conversion to laparotomy, among whom seven cases were placed drainage tube. The mean postoperative hospital stay was 3 days. No bile leakage, extrahepatic bile duct injury or death oceured, and the type-B ultrasonic rechecking was normal one month later. Coneluslons：LC with the improved method can effectively prevent injury of extrahepatic bile duct.