胆囊管增粗在腹腔镜胆囊切除术中的处理体会

Management of enlarged cystic duct in laparoscopic cholecystectomy

目的 探讨腹腔镜胆囊切除术中胆囊管增粗的处理方法。方法 自 2 0 0 1年 3月至 2 0 0 3年 5月 ,对3 1例胆囊管增粗病人行腹腔镜胆囊切除术 ,其中胆囊管直径 0 4～ 0 6cm 2 0例 ,直径 >0 6～ 0 8cm 6例 ,直径 >0 8cm 5例。在腹腔镜胆囊切除术中分别采用阶梯施夹法 (2 2例 )、大号钛夹法 (4例 )、圈套器法 (5例 )三种方法处理胆囊管 ,14例置腹腔引流管。结果 3 0例无并发症治愈出院 ,1例术后第 2天出现胆漏 ,经内镜下逆行胰胆管造影术 (ERCP) +内镜下鼻胆管引流术 (ENBD)及腹腔引流 1个月后治愈出院。结论 在腹腔镜胆囊切除术中 。

ObjectiveTo explore the management of enlarged cystic duct in l aparoscopic cholecystectomy.MethodsFrom March 2001 to May 2003 ,31patients w ith enlarged cystic duct underwent laparoscopic cholecystectomy. The diameter o f cystic duct was 0 4- 0 6cm in 20 cases,larger than 0 6- 0 8cm in 6 cases and larger tha n 0 8 cm in 5 cases.Three treatment methods were performed: step claps method (n=22 ),large size endoclip method (n=4) and endoloop method (n=5).And intra- abdominal dr ainage tubes were placed in 14 cases.ResultsThirty patients we re discharged from hospital without complications;1 patient had bile leakage on the 2nd postoperat ive day,who recovered one month later by successful treatment by ERCP, ENB D and intra-abdomina l drainage. ConclusionSuitable methods should be taken to manage enlarged cystic duct in laparoscopic cholecystectomy.