LC术胆管损伤的危险因素及术后分析  

Risk factors and postoperative analysis of bile duct injuries during laparoscopic cholecystectomy

作　　者：王宏[1] 罗建管 梁鹏[1] 易旭华[1] 李虎山[1] 肖怀忠[1] 杨明[1] 

机构地区：[1]湖南省浏阳市人民医院肝胆外科,湖南浏阳410300

出　　处：《肝胆胰外科杂志》2011年第4期296-298,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的分析LC术胆管损伤的危险因素,并对胆管损伤术后进行分析。方法回顾性分析本院1999年10月至2010年12月行LC术的4 531例患者所出现的41例胆管损伤,对胆管损伤的各影响因素进行χ2检验,分析胆管损伤的独立危险因素;同时分析胆管损伤是否能在术中及时发现。结果单因素分析显示:患者性别、炎症分期、B超示胆囊壁厚度、胆囊三角解剖和手术经验与胆总管损伤有关联(P<0.05)。多因素非条件Lo-gistic回归分析结果显示:胆囊三角解剖和手术经验是胆管损伤的独立危险因素(P<0.05)。胆管损伤术中发现例数明显多于术后发现例数(χ2=12.868,P<0.05)。结论患者性别、炎症分期、B超示胆囊壁厚度、胆囊三角解剖和手术经验与胆总管损伤密切相关。胆囊三角解剖和手术经验是胆管损伤的独立危险因素。胆管损伤一般能在术中及时发现及处理。Objective To analyze the risk factors of bile duct injuries during laparoscopic cholecystectomy and postoperative bile duct injuries.Methods Forty-one cases of bile duct injuries were analyzed retrospectively in 4 531 cases of laparoscopic cholecystectomy between October 1999 to December 2010.All influential factors were checked in chi square,and independent risk factors about bile duct injuries were simultaneously analyzed.At the same time,whether bile duct injuries could be detected intraoperatively in time was analyzed.Results Univariated analysis showed bile duct injuries were associated with gender,stagings of inflammation,thickness of cholecystic wall by sonography,anatomy of Calot＇s triangle and surgical experience（P0.05）.Anatomy of Calot＇s triangle and surgical experience were independent risk factors of bile duct injuries（P0.05）.The numbers of bile duct injuries detected intraoperatively were more than those postoperatively（χ2=12.868,P0.05）.Conclusion Bile duct injuries associate with gender,stagings of inflammation,thickness of cholecyst wall by sonography,anatomy of Calot＇s triangle and surgical experience closely.Anatomy of Calot＇s triangle and surgical experience are independent risk factors of bile duct injuries.Bile duct injuries can be detected intraoperatively in time.

关 键 词：胆囊切除术 腹腔镜 胆管损伤 危险因素 

分 类 号：R657.4[医药卫生—外科学]