腹腔镜胆囊切除术后胆管损伤发生状况及高危因素分析

Analysis of the occurrence of bile duct injury and high-risk factors after laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术后胆管损伤发生状况及高危因素。方法选择上饶市广丰区裕丰医院2017年1月—2020年1月收治完成LC治疗并获得随访的112例患者,包括56例发生术后胆管损伤的观察组和56例未发生术后胆管损伤的对照组,回顾性分析其病历资料,统计并整理患者性别、年龄、手术时间、合并基础疾病、胆囊壁厚度、胆囊三角解剖、术中粘连、胆囊管长度、胆囊管切断顺序、胆囊炎合并症等基线资料。记录LC术后胆管损伤发生状况和独立危险因素。结果采用LC治疗的112例患者术后有56例发生胆管损伤,胆管损伤发生率为50.00%(56/112);腹腔镜胆囊切除术后胆管损伤发生的独立危险因素包括胆囊壁厚度>4 mm、胆囊三角解剖变异、术中粘连紧密、胆囊管长度≤10 mm。结论腹腔镜胆囊切除术后胆管损伤发生率较高,患者胆囊壁厚度>4 mm、胆囊三角解剖变异、术中粘连紧密、胆囊管长度≤10 mm均为其独立危险因素,须给予早期预防和干预,确保手术过程顺利完成,改善患者预后。

Objective To investigate the occurrence of bile duct injury and high-risk factors after laparoscopic cholecystectomy.Methods We selected 112 patients who completed LC treatment and were followed up from January 2017 to January 2020,including 56 observation group with postoperative bile duct injury and 56 control group without postoperative bile duct injury.,Retrospectively analyze the case data,count and sort the baseline data of the patient's gender,age,etc.,and record the occurrence of bile duct injury and possible high-risk factors after LC.Results The high-risk factors for bile duct injury after laparoscopic cholecystectomy included the thickness of the gallbladder wall>4 mm,the anatomical variation of the gallbladder triangle,tight intraoperative adhesions,and the length of the cystic duct≤10 mm.Conclusion Patients with gallbladder wall thickness>4mm,anatomical variation of the gallbladder triangle,tight intraoperative adhesions,and cystic duct length≤10mm are all high-risk factors for cystic duct injury after laparoscopic cholecystectomy.Conclusion Medical personnel must carry out early prevention and intervention for surgical patients.Provide reference to ensure the smooth completion of the surgical process and improve the prognosis of patients.