摘要
目的 :探讨小切口胆囊切除术 (Minicholecysectomy ,MC)后胆漏的原因及预防措施。方法 :对本院 1991年 4月至 2 0 0 2年 12月 6 10 0例MC术后发生胆漏 2 3例 (0 38% )的原因进行回顾和分析。结果 :4例 (17 4 % )行再次手术引流和 18例 (78 3% )经非手术治疗均治愈 ,1例(4 3% )高龄患者死于肺心病。结论 :严格选择MC适应证 ,仔细分辨Calot三角解剖结构 ,正确掌握缝扎胆囊三角系膜技术 ,把握术中延长切口的时机是预防胆漏并发症的关键。
Objective:To study causes and precaution of biliary fistula after minicholecysectomy(MC).Methods:Review and analyse 23(0.38%) patients of biliary fistula among 6 100cases who underwent MC from April,1991 to December,2002.Results:22 patients had healed.18(78.3%) cases healed without reoperation;4(17.4%) cases underwent surgical operation again;1(4.3%) case died from advanced age with pulmonary heart disease.Conclusion:It must grasp indication of MC strictly,distinguish anatomical structure of calot trigone carefully as well as suture gallbladder Calot meseutery correctly.It is the key step that grasp proper occasion of lengthen incision to avoid complications such as biliary fistula.
