腹腔镜胆囊切除术胆管损伤原因分析

Factor of bile duct injury during laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术胆管损伤原因和预防措施。方法对2009年10月至2012年12月15 137例腹腔镜胆囊切除术中的22例胆管损伤病例进行回顾性分析。结果 22例胆管损伤中,因胆道解剖变异或病理变异致伤18例;盲目止血致伤1例;操作失误3例。结论胆道解剖变异、病理变异和医生的临床经验是导致腹腔镜胆囊切除术胆管损伤的重要因素。严格的腹腔镜外科训练,丰富的胆道外科经验及正确对待中转开腹的态度是避免胆管损伤的有效措施。

Objective To investigate the causes and prevention of bile duct injury during laparoscopic cholecysteetomy. Methods 22cases of iatrogenic bile duct injury during laparoscopic cholecystectomy were reviewed and analyed from October 2009 to December 2012. Result Among 22 cases, 18 cases were caused by anatomic variation and pathological variation of biliary tract, 1 case was caused by blindly hemostasis and 3 cases were caused by surgeon＇ s operative errors. Conclusion The anatomic variation of biliary tract,patho- logical variation and the clinical experience of doctors were important 14sk factors of bile duct injury. The critical laparoscopic surgical training,abundant bilary surgery experience and the rigt attitute to coverting to an open cholecystectomy may be effective measure to avoild bile duct injury during laparoscopic cholecystectomy.