胆囊管变异与胆囊切除术

VARIATION OF CYSTIC DUCT AND CHOLECYSTECTIOMY

目的：胆囊切除术是腹部外科的常见手术之一，胆囊管的处理是胆囊切除术的关键步骤，胆囊管的变异可造成手术的困难，也是胆道医源性损伤的一个主要原因。方法：回顾性分析我院２０年来在胆囊切除术中发现的１２５例胆囊管变异，对其两全是分型及术中的处理方法作一探讨。结果：术中胆总管损伤８例，胆囊管处理不当致术后形成胆汁性腹膜炎４例，全组无死亡。结论：胆囊管的变异是造成胆囊切除术中胆道医源性损伤的主要原因。

Objective: Cholecystectomy is one of the common surgical operation in abdominal surgery. In which the keep procedure is the treatment of cystic duct. Variations of cystic duct may cause difficulties in the operation and are also a main reason of biliary tract injury, which may be decreased if surgical can enhance their realization of variation and keep alert on them. Methods: A retrospective analysis was conducted of 125 patients who were found with variation of cystic duct during cholecystectomy in recent 20 years. And the pathological type and corresponding treatments during operations were also discussed. Results: 8 patients were found with common bile duct injury during operating; 4 patients suffered biliary peritonitis which resulted from incorrect treatment of cystic duct; all of the patients no one died. Conclusion: The variation of cystic duct is the main cause of biliary tract injury, to which corresponding treatment shauld be taken during the operation.