腹腔镜胆总管探查T管引流术后胆漏的发生原因及对策  

Causes and management for bile leakage after T-tube drainage of laparoscopic bile duct exploration

作　　者：林江[1] 戴德祥[1] 陈安平[2] 

机构地区：[1]成都铁路分局医院外科,四川成都610041 [2]成都市第二人民医院肝胆胰外科,四川成都610017

出　　处：《海南医学院学报》2008年第6期707-709,共3页Journal of Hainan Medical University

摘　　要：目的:探讨腹腔镜胆总管探查T管引流术后胆漏的发生原因、预防方法及处理措施。方法:对395例腹腔镜胆总管探查T管引流术后21例胆漏患者的临床资料进行回顾性分析。结果:胆管切口漏胆13例,其中4例经术中常规放置的腹腔引流管引流自愈,9例联合内镜乳头切开和鼻胆管引流治愈。术后T管早期滑脱4例和常规拔T管4例均导致胆汁性腹膜炎,经再次手术置T管和腹腔引流管治愈。结论:腹腔镜胆总管探查T管引流术后胆管切口漏胆、术后T管早期滑脱和T管瘘道形成不全是胆漏发生的主要原因,保持或建立通畅的腹腔引流和胆管引流是治疗胆漏的主要处理措施。Objective： To investigate the causes, prevention and management of bile leakage after T- tube drainage of laparoscopic bile duct exploration（TLBDE）. Methods： Datas of 21 bile leakage cases out of 395 TLBDE procedure performed in our department were retrospectively analyzed. Results： Bile leakage of 13 cases caused by the bile from exploratory incision of biliary duct to leak through into the peritoneal cavity was cured by patent drainage of TLBDE in 4 cases and endoscopic drainage in 9 cases. Peritonitis of bile leakage was cured by surgery and patent drainage in 8 cases. Conclusion： The main causes of bile leakage after TLBDE were the unhealed incision of the bile duct, early slip out of the T-tube, incomplete T-tube fistula. Patent drainage and T-tube drainage are the main methods for the treatment of bile leakage after TLBDE.

关 键 词：腹腔镜 胆总管探查术 胆漏 

分 类 号：R657.4[医药卫生—外科学]