腹腔镜下胆囊壶腹皱襞入路胆囊切除术预防胆道损伤的临床效果

Clinical effect of laparoscopic cholecystectomy via gallbladder ampullary fold approach in prevention of bile duct injury

目的探讨经胆囊壶腹皱襞入路的腹腔镜胆囊切除术(LC)在预防胆道损伤中的临床效果,为临床应用提供指导。方法选择2015年12月至2016年5月鄂尔多斯市中心医院康巴什部经胆囊壶腹皱襞入路精细解剖胆囊三角技术行LC的120例胆囊结石及胆囊息肉患者为研究对象,对其临床资料进行分析。结果以胆囊壶腹与肝十二指肠韧带之间的凹陷或切迹(即胆囊壶腹皱襞)为解剖学标志,显露胆囊管、肝总管、胆总管及胆囊动脉,120例患者均顺利完成了LC,术中未发生胆道损伤。结论在LC中采用经胆囊壶腹皱襞入路可有效预防术中胆道损伤的发生,值得临床推广应用。

Objective To investigate the clinical effect of laparoscopic cholecystectomy(LC)via gallbladder ampullary fold approach in prevention of bile duct injury,and to provide guidance for clinical application.Methods From December 2015 to May 2016,120 patients with gallbladder stones and gallbladder polyps who underwent LC with the technique of fine anatomy of the gallbladder triangle through the gallbladder ampullary fold approach in the Kangbashi branch of the Ordos central hospital were selected as the research objects,and the patients clinical data were analyzed.Results Taking the depression or notch between the ampulla of gallbladder and hepatoduodenal ligament(namely gallbladder ampullary fold)as the anatomical mark,the cystic duct,common hepatic duct,common bile duct and cystic artery were exposed.All 120 patients successfully completed LC,and without bile duct injury.Conclusion In the LC,the gallbladder ampullary fold approach can effectively prevent intraoperative bile duct injury,which is worthy of clinical promotion and application.