腹腔镜胆囊切除术中胆囊壶腹后开窗法预防胆道损伤的体会  

The experience of gallbladder posterior ampulla fenestration in laparoscopic cholecystectomy to avoid biliary duct injury

作　　者：尹耀新[1] 殷良春[1] 熊沛[1] 彭毅[1] 龙光辉[1] 钟立明[1] 周晓初[1] 叶建宇[1] 

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《腹腔镜外科杂志》2008年第1期75-77,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨预防腹腔镜胆囊切除术中胆道损伤的方法。方法:回顾分析2004年5月至2007年2月使用胆囊壶腹后开窗法施行腹腔镜胆囊切除术1 480例患者的临床资料。结果:1例有上腹部手术史,1例有急性胰腺炎发作史,腹膜腔几乎闭塞,气体膨胀困难,遂中转开腹。2例术中快速冰冻病理提示意外胆囊癌,中转开腹行胆囊癌根治术,1 480例中无一例胆道损伤及其他并发症发生。术后平均住院3.5d。结论:胆囊壶腹后开窗法有助于术中辨认肝外胆管的解剖结构及变异,能有效减少胆道损伤。Objective：To investigate how to avoid the biliary duct injury caused by laparoscopic cholecystectomy（LC）. Methods：The clinical data of 1480 patients received LC using gallbladder posterior ampulla fenestration （GPAF） was retrospectively reviewed from May. 2004 to Feb. 2007. Results：Two cases were converted to open cholecystectomy（OC） due to severe adhesion of peritoneal cavity. Two of them were converted to open operation due to accident gallbladder cancer. No biliary duct injury and other complications occurred in all cases. The average postoperative hospitalization was 3.5 days. Conclusions ： GPAF can help to discriminate biliary duct anatomy variation and is effective to avoid biliary duct injury.

关 键 词：胆囊切除术 腹腔镜 胆道损伤 并发症 

分 类 号：R657.4[医药卫生—外科学]