腹腔镜胆囊切除术2800例术中胆囊床的处理

Management of gallbladder bed during laparoscopic cholecystectomy: Experience of 2 800 cases

目的探讨腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）中胆囊床的处理方法。方法回顾分析我院1997年9月一2005年8月2800例LC的临床资料。结果在胆囊床的处理过程中，有2570例采用常规方法处理，46例采用非常规方法，余184例采用常规与非常规相结合的方法处理。12例胆漏，经充分引流治愈。26例胆囊床出血，1例术后2h行剖腹探查，余25例为术中出血。结论LC术中胆囊床的处理应根据术中所见胆囊床的具体类型来决定，一旦发生胆漏或出血等并发症，不应盲目处理，需视具体情况采取相应措施。

Objective To investigate the management of gallbladder bed during laparoscopic cholecystectomy （LC）. Methods Clinical data of 2 800 cases of LC from September 1997 to August 2005 in this department were retrospectively analyzed. Results Out of the 2 800 cases, the gallbladder bed was managed by conventional methods in 2 570 cases, by unconventional methods in 46 cases, and by combination of conventional and unconventional methods in 184 cases. Bile leakage happened in 12 cases, and was cured after drainage. Hemorrhage from the gallbladder bed occurred in 26 cases, in 1 of which a re-operation of open exploration was given 2 hours after LC and in the remaining 25 of which intraoperative hemorrhage was stopped immediately. Conclusions During laparoscopic cholecystectomy, management methods of the gallbladder bed depend on actual types of the gallbladder bed. Once complications such as bile leakage or hemorrhage occurred, countermeasures corresponding to specific circumstance should be employed.