腹腔镜胆囊切除术后胆漏的原因及对策

Causes and Countermeasures of Bile Leakage After Laparoscopic Cholecystectomy

目的探讨腹腔镜胆囊切除术后胆漏的原因及临床相应处理对策。方法随机选取2010年1月至2015年2月于本院接受腹腔镜胆囊切除手术的50例患者为研究对象,随机分为两组各25例,对照组采取常规对症处理,观察组对相关危险因素制定、实施针对性干预对策。结果观察组患者的住院时间和胆漏发生率均显著少于对照组,生活质量评分显著高于对照组(均P<0.05)。结论腹腔镜胆囊切除术后发生胆漏的主要原因为胆管灼伤、胆囊管残段漏、迷走胆管损伤、毛细血管胆管损伤,临床应积极调查相关危险因素,并实施针对性的干预对策,以促进患者康复,降低胆漏发生率,提高患者生活质量。

Objective To explore the reasons of bile leakage after laparoscopic cholecystectomy and corresponding clinical treatment countermeasures. Methods A total of 50 cases of patients with laparoscopic cholecystectomy admitted to our hospital from January 2010 to February 2015 were selected and randomly divided into two groups, with 25 cases in each group. The control group received routine symptomatic treatment, while in the observation group, the related risk factors were analyzed and targeted intervention countermeasures were developed and implemented. Results The length of hospital stay of observation group was significantly shorter than that of control group （P 〈0.05）, the incidence of bile leakage was significantly lower than that of control group （P 〈0.05）, and the score of quality of life was significantly higher than that of control group （P 〈0.05）. Conclusions The main causes of bile leakage after laparoscopic cholecystectomy are bile duct injuries, cystic duct siump leakage, vagus bile duct injury and blood capillary bile duct injury. Clinicians should investigate the related risk factors actively, and implement corresponding intervention countermeasures to promote patients recovery, reduce the incidence of bile leakage, and improve patients＇ quality of life.