腹腔镜胆囊切除术胆道损伤的预防及处理

Prevention and treatment of bile duct injury resulting from cholecystectomy via celioscopy

目的:总结腹腔镜胆囊切除术胆道损伤发生的原因、处理方法及预防措施。方法:回顾收治的9例腹腔镜胆道损伤患者的临床资料,分析其发生的原因、部位、处理方法和治疗效果。结果:经胆管壁修补、胆管对端吻合或胆肠吻合术后8例痊愈,占88.9%。1例术后出现吻合口漏,占11.1%。结论:腹腔镜胆囊切除术术前正确选择病例,术中规范操作,是防止胆道损伤的有效措施;胆道损伤早期发现和正确处理对预后十分重要。

Objective To Summarize the causes of bile duct injury resulting from cholecystectomy via celioscopy, and to find out the ways to its treatment and prevention. Method The clinical data of 9 patients with bile duct injury resulting from cholecystectomy via celloscopy, who were admitted to the hospital in the recent seven years, were reviewed. The causes and the location of bile duct injury were analyzed, as well as its treatment and outcome. Results Out of the 9 patients,8 （88.9%） were completely healed up by bile duct wall repair, choledocholedochostomy or choledochojejunostomy. The other one （ 11.1% ） suffered from postoperative fistula at the anastomotic stoma. Conclusion Proper selection of the patients before celioscopic cholecystectomy and the standardized procedure during the operation that act as the effective measure to the prevention of bile duct injury, in which early discovery and correct treatment of bile duct injury play important roles.