直视微创胆道手术技巧的探讨  

Minimally invasive biliary tract surgery under direct view

作　　者：邓剑[1] 胡斌[1] 赵叶平[1] 邓鲲[1] 徐稳深[1] 徐广明[1] 

机构地区：[1]广东省博罗县人民医院外一科,516100

出　　处：《中国实用医刊》2009年第16期22-23,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨直视微创胆道手术的操作技巧，提高手术质量。方法应用MEBS系列器材和相应的手术步骤，直视下采用刮吸、推剥和缝吊等操作技巧解剖胆囊三角区域并行肝外胆道手术。结果直视微创操作完成胆囊摘除98例，胆总管切开“T”管引流10例，胆总管一十二指肠吻合7例。相关手术技巧的应用使术中解剖更为清楚，出血量减少，手术时间缩短。术后迷走胆瘘1例，经缝扎瘘口后痊愈出院。无术后出血、黄疸和切口感染等并发症，无死亡病例。结论MEBS具有LC相同的微创效果，相应的操作技巧应用使手术更为安全简捷。Objective To study the operative technique of the minimally invasive biliary tract surgery and improve the quality of surgery. Methods By applying MEBS operative instruments, extrahepatic duct operations were performed by using suction, dissection and suspension technique under direct view. Results Ninety - eight cases of cholecystectomy, 10 cases of choledochalithotomy with T - tube drainage and 7 cases of choledochoduodenostomy were performed successfully without any postoperative complication. This kind of invasive operative method can provide clear operative view with less operative time and bleeding. There was 1 case of abberant bile duct fistula, which was cured by transfixion of fistula. There was no complication of bleeding, jaundice, and incision infection, and no patient died after operation. Conclusions This method can not only achieve the minimally invasive effect of laparoscopy operation, but can improve clinical safety.

关 键 词：直视 微创 肝外胆道 

分 类 号：R657.4[医药卫生—外科学] R734.2[医药卫生—临床医学]