腹腔镜医源性胆管损伤的原因及处理

The causes of biliary ducts injury and prophylaxis treatment in laparoscopic cholecystectomy

目的 :分析腹腔镜胆囊切除术医源性胆管损伤的原因 ,探讨防治措施。方法 :回顾分析 2 0 0 2 2例腹腔镜胆囊切除术中 2 9例胆管损伤的临床资料。结果 :2 0例行胆管端端吻合、T管支撑引流术 ,4例行胆-肠吻合术 ,3例行T管切开支撑引流术 ,2例行钛夹取出术 ,均获满意疗效。结论 :胆道损伤是腹腔镜胆囊切除术的主要严重并发症 ,正确操作可避免损伤 ,胆道损伤术中及术后适时正确处理 ,一般预后良好。

Objective:To explore the causes of biliary ducts and prophylaxis treatment in laparoscopic cholecystectomy(LC).Methods:The causes and treatments of 29 cases with biliary ducts injury from 20 022 LC were retrospectively analysed.Results:Lacing knowledge of the danger and experience,increasing the operation adaptation deliberately,inaccruately operating,unsuitably using instrument,and being unable to discern calot triangle were the main causes.In this group,20 cases were performed bile duct opposite anastomosis and T tube drainage,4 cases were pertormed cholangio-jejunostomy,3 cases were performed T tube insection drainage,2 cases were performed titanium damp extration.All got satisfied result.Conclusions:Biliary ducts injury is serious complication which can be avoided by accurately operating.