胆囊切除术中胆道变异识别与处理

Identification and management of anatomical variations of biliary tree in cholescystectomy

由于高达50%的胆囊结石或胆总管结石等良性疾病病人合并有不同类型的解剖变异,这些变异区别于普遍认知的常规解剖模式,忽视这些变异将有可能导致灾难性的医源性胆道损伤。因此,系统掌握各种胆道解剖变异的知识是外科医生进行安全的胆囊切除术的关键。

A good working knowledge of the incidence and types of anomaly or variation is key to a safe cholecystectomy, as 50% of patients presenting with gallbladder stones or common bile duct stones show a significant variation from what is generally considered as the expected normal pattern. Ignorance of the anomalies may well be responsible for catastrophic injuries of the bile duct during laparoscopy. Understanding possible anatomical variations systematically is the key for surgeons to perfom cholecystectomy safely.