腹腔镜胆囊切除术胆管损伤的预防

Prevention of Bile Duct Injury Caused in the Laparoscopk Cholecystectomy

目的:探讨腹腔镜胆囊切除术胆管损伤的预防。方法:回顾性分析1998～2001年间305例腹腔镜胆囊切除术病人临床资料。结果:成功298例,中转开腹7例,切口感染2例,肺部感染1例,胆总管残余结石2例,全组无1例胆管损伤。结论:腹腔镜胆囊切除术胆管损伤的预防必须注意以下几点:①严格掌握手术适应证;②固定而成熟的手术组成员;③正确的麻醉选择;④规范手术操作,及时中转开腹;⑤术者须具有高度的责任感和警惕性。

Objective: To study the prevention of the bile duct injury caused by LC. Methods.-The clinical data of 305 cases performed by LC from 1998 to 2001 were analysed.Results:298 cases were successful.Only 7 cases were turned to paunch operation. Postoperative wound infection occured in 2 cases, and pulmonary infection in 1 case, choledocholithiasis in 2 cases None complicated bile duct injury. Conclusion .-Five aspects must be emphasized in the prevention of the bile duct harms during LC.(1)To select application strictly;(2)The operational members must be fixed and experienced;(3)To select anesthesia correctly;(4)To normalize operational manipulation and convert to paunch operation decidedly and seasonably; (5)The operators must have high responsibility and precaution during operations.