腹腔镜胆囊切除术中医源性胆管损伤的预防

Preventive strategies for the iatrogenic bile duct injury in laparoscopic cholecystectomy

腹腔镜胆囊切除术(LC)目前已定位为良性胆囊疾病的金标准手术。医源性胆管损伤(iatrogenic bile duct injury,IBDI)是其最严重的并发症之一。如发现不及时或处理不当都可能引起严重后果。因此,LC引发的胆管损伤应引起足够的重视。术者经验不足、局部粘连严重、出血、胆道解剖变异等是导致胆管损伤的主要原因。了解LC发生IBDI的风险因素,正确处理IBDI,对避免威胁病人生存质量的后果有非常重要的意义。

The laparoscopic cholecystectomy （LC） has become the golden standard for the benign disease of the cholecyst, whereas iatrogenic bile duct injury （IBDI） is one of its most severe complications, which may result in severe complications if not been found or treated in time. Thus it should attach sufficient importance to the IBDI in LC. The primary causes of IBDI include inexperience of operators, severe local conglutination, intraoperative hemorrhage, bile duct anatomic aberrance and so on. There is great significance for surgeons to realize the risk factors and deal with IBDI appropriately.