腹腔镜胆囊切除术胆管损伤的防治

Prevention and treatment of bile duct injury in laparoscopic cholecystectomy

目的 :探讨腹腔镜胆囊切除术 (LC)致胆管损伤的原因及预防。方法 :回顾分析腹腔镜胆囊切除术 192 0例的临床资料。发生胆管损伤 6例 ,发生率为 0 31%。分析损伤的部位、类型、发生时间、原因、手术方法及采取的预防措施体会。结果 :本组 6例全部治愈 ,随访 1～ 6年 ,除 1例胆管狭窄及胆管炎外 ,余 5例健康状况良好。结论 :预防胆管损伤是关键 ,加强对LC操作训练及规范LC操作的重视。应根据发现胆管损伤的时间、部位。

Objective:To study the prevention and treatment of bile duct injury in laparoscopic cholecystectomy Methods:The clinical data of 1 920 cases with laparoscopic cholecystectomy were retrospectively analyzed 6 cases had bile duct injury The incidence was 0 31% The positions of injury, the types, the incident time, the causes, the methods of surgery and the experiences of provention were studied Results:All were cured Followed from 1 to 6 years, 1 case occurred bile duct stricture and cholangitis, and the other 5 were in good health Conclusions:To prevent injury, the operator should pay more attention to improving LC skill and formate criterion of LC operation The treatment of bile duct should choice different methods according to the incident time, the position, the types and so on