摘要
目的总结腹腔镜胆囊切除术中胆管损伤的预防和处理的经验与教训。方法分析腹腔镜胆囊切除术中胆管损伤常见原因、预防措施及处理方式。结果胆总管损伤3例行修补术加胆总管T管引流,肝总管损伤1例,外院腹腔镜胆囊切除术胆总管横断损伤转入1例及1例右侧副肝管行胆肠吻合术,l例为外院胆总管损伤初次修复术后出现胆总管梗阻再次行胆肠RouxY吻合术。结论术中辨认清楚胆囊三角和胆囊管、胆总管、肝总管、胆囊壶腹结构及“三管、一壶”关系极重要,手术时如解剖不清严重粘连应及时中转开腹手术。
Objective To investigate the prevention and treatment of bile duct injury in laparoscopic cholecystectomy. Methods The treatment of eight patients with bile duct injury was reviewed during their laparoscopic cholecystectomy and its causation was analysed so that our effective experience would be recommend. Results Three cases of bile duct injury were operated by repair operation and T-tube drainage. There respectively was one case with general hepatic duct injury, one with general bile duct intersection after laparoscopic cholecystectomy in other hospital and one with right accessory hepatic duct injury. They were all operated by cholecystojejunostomy. One case of right hepatic duct injury was performed with repair. One case of general bile duct obstruction aftel first injury in laparoscopic cholecystectomy in other hospital was operated by Roux-Y cholecystojejunostomy. All the eight cases were healed up after our operation. Conclusion It is important to distinguish the anatomy of Charcot＇s triangle, bile duct, general bile duct, general hepatic duct and their relationship. Those who suffered severe adhesion and unclear anatomy should be converted to laparotomy.
出处
《临床军医杂志》
CAS
2005年第5期567-568,共2页
Clinical Journal of Medical Officers
关键词
腹腔镜胆囊切除术
胆管损伤
laparoscopic cholecystectomy
bile duct injury
