腹腔镜胆囊切除术致胆管损伤的临床诊疗进展

Advances in clinical diagnosis and treatment of bile duct injury caused by laparoscopic cholecystectomy

胆管损伤是腹腔镜胆囊切除术的严重并发症之一.腹腔镜胆囊切除术所致胆管损伤的分型、诊断、治疗尚有存在争议之处.胆管损伤的分型最适用的有Strasberg-Bismuth分型和较完善的中华医学会外科学分会胆道外科学组提出的3型4类.虽然腹腔镜胆囊切除术所致胆管损伤术中诊断率低,但术后临床表现及辅助检查常有助于诊断.而准确的分型和及时诊断有助于制定个体化方案.本文现就腹腔镜胆囊切除术所致胆管损伤的诊疗进展作一综述.

Bile dut injury （BDI） is one of the severe complications of laparoscopic cholecystectomy （LC）.The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth＇s classification and the ＂three modes and four classes＂ developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.