腹腔镜胆囊切除术后并发胆漏3例

After Laparascopic Cholecystecystectomy Bile Leakage in 3 Cases

目的分析腹腔镜胆囊切除（LC）术后并发胆漏的原因。方法回顾武穴市妇幼保健院2006-2011年三例腹腔镜术后并发胆漏，其中1例胆总管损伤，2例胆囊管残端钛夹滑脱。结果对1例胆总管损伤的处理是：开腹将损伤的胆总管损伤部位切开并放置T管引流，术后三个月痊愈。对两例胆囊管残端钛夹滑脱的处理是：于术后第3天用腹腔镜探查，找到残端上钛夹并放置腹腔引流管，术后一周痊愈。结论腹腔镜术后胆漏的主要原因是手术操作不慎电钩灼伤胆总管，处理胆囊管残端上钛夹时忽略了钛夹咬舍是否稳妥。

Objective To analyze the reasons of the concurrent bile leakage after laparoscopie choleeysteetomy.Methods We summarized three eases of laparoseopie postoperative bile leakage in patients of Wuxue Maternal and Child Health Hospital in 2006-2011.One ease was the bile duet injury and the other two eases were cystic duet stump titanium clip slippage.Results For the case of bile duet injury, we opened the common bile duct injury site of incision and placed T-tube drainage, the patient recovered in three months. For the two eases of cystic duet stump titanium clip slippage, we used laparoseopie exploration to find the stump with the new titanium clip reinforcement and placed peritoneal drainage tube in the third day after surgery, the patient recovered in one week.Conclusion Laparoscopic bile leakage was mainly due to the careless operation of surgery, such as the electrical hook burned the common bile duct and ignored whether the titanium clamp is occlusive finn when deal with the cystic duct stump.