摘要
目的 探讨如何预防腹腔镜胆囊切除术中胆管损伤。方法 回顾分析 1993年 3月至 2 0 0 4年 9月 3 3 81例腹腔镜胆囊切除术的临床资料。结果 胆管损伤 2例 (0 .0 5 9%) ,其中 1例死亡 ,另 1例行胆肠吻合治疗 ;71例 (2 .1%)因胆囊严重粘连、胆囊萎缩、胆囊动脉出血或既往有上腹部手术史 ,致使腹腔广泛粘连者中转开腹。术后漏胆 3例 ,因钛夹滑脱致胆囊动脉出血再次腹腔镜手术 1例。术后 3～ 14d平均 4.6d出院。结论 腹腔镜胆囊切除术应严格选择病例 ,仔细处理calot三角 ,适时中转开腹 ,术者熟悉肝门解剖 ,避免盲目自信是预防胆管损伤的重要措施。
Objective To discuss how to prevent bile duct injury caused by laparoscopic cholecystectomy (LC).Methods To analyze the clinical materials of 3381 patients who underwent LC during Mar 1993 and Sept 2004.Results There were 3304 patients experienced postoperation course successfully,71 patients were converted to open cholecystectomy (OC) because of severe acute cholecystitis,atrophic cholecystitis,mass bleeding of gallbladder artery,and severe abdominal adhesion.Two patients suffered from bile duct injury.Three patients suffered from bile leakage,and 1 patient underwent 2nd time LC because of gallbladder artery bleeding.All patients recoveried in 3 to 14 days postoperatively.Conclusion The indications of LC should be strictly selected.It should be emphasized that Calot triangle be dissected precisely,if impossible,converted to OC immediately.The surgion should be familiar with hilar anatomy and avoiding overconfidence.
出处
《四川医学》
CAS
2005年第3期258-260,共3页
Sichuan Medical Journal
关键词
腹腔镜
胆囊切除术
并发症
胆管损伤
laparoscopic cholecystectomy
complication
bile duct injury
prevent
