胆囊壶腹部切开结合圈套器在腹腔镜胆囊切除术中的应用

Application of the incision of Hartmanns gallbladder pouch combined with the snare in laparoscopic cholecystectomy

目的探讨胆囊壶腹部切开结合圈套器在腹腔镜胆囊切除术中的应用及其适应证和优越性。方法回顾性分析2005年7月至2009年7月对行腹腔镜胆囊切除术中由于各种原因导致胆囊管分离解剖困难者111例,术中应用胆囊壶腹部切开结合圈套器行胆囊管部位结扎的临床资料。结果术后所有病人均恢复良好,无一例发生胆漏、胆管损伤、出血、黄疸及胆囊管残端残余结石等并发症。结论腹腔镜胆囊切除术中胆囊管分离解剖困难,应用胆囊壶腹部切开结合圈套器行胆囊管部位的结扎安全可行,优势明显。

Objective To explore the clinical application of the incision of the Hartmanns gallbladder pouch combined with the snare in laparoscopic cholecystectomy（LC）, and its indications and advantages. Methods From July 2005 to July 2009,111 cases of the adhesive cystic duct due to varied causes in LC received the ligation of cystic duct by using the incision of Hartmanns gallbladder pouch combined with the snare, and their clinical data were retrospectively analyzed. Results No bleeding, jaundice, biliary leakage, bile duct injury and other complications occurred in 111 cases. Conclusion It is suitable,safe and superior to ligate the cystic duct by using the incision of Hartmanns gallbladder pouch combined with the snare when the Calot triangle was dissected difficultly in LC.