腹腔镜胆囊切除术后迟发性胆漏17例临床分析  

Clinical analysis of delayed bile leakage after laparoscopic cholecystectomy:a report of 17 cases

作　　者：董宇[1] 靳红旗 李昱 周金榜 赵军[2] 

机构地区：[1]武警工程大学医院普外科,西安710086 [2]西安交通大学医学院第二附属医院普外科

出　　处：《山西医科大学学报》2012年第7期531-533,共3页Journal of Shanxi Medical University

摘　　要：目的探讨腹腔镜胆囊切除术后迟发性胆漏的原因、诊治方法及预防措施。方法对本院收治的17例腹腔镜胆囊切除术后发生迟发性胆漏病例进行回顾性分析。结果迟发性胆漏原因:15例为胆管电灼损伤、1例为迷走胆管电灼损伤后焦痂脱落,1例为胆囊管钛夹脱落。17例患者经再次手术引流,其中3例同时行鼻胆管引流,均治愈。结论胆管及迷走胆管电灼伤后焦痂脱落是引起腹腔镜胆囊切除术后迟发性胆漏的主要原因,通畅引流是治疗腹腔镜胆囊切除术后迟发性胆漏的简单、安全、有效方法。Objective To explore the cause,diagnosis,treatment and prevention of delayed bile leakage after laparoscopic cholecystectomy（LC）.Methods The clinical data of 17 patients suffering from the delayed bile leakage after LC from January 2005 to December 2011 were collected and analyzed retrospectively.Results The delayed bile leakage after LC was caused by the electric burn of bile duct in 15 cases,the electric burn of aberrant bile duct in one case and the loosed titanium clips on the cystic duct in one case.All patients were cured after re-operation and peritoneal drainage,of whom,3 patients were performed endoscopic nasobiliary drainage（ENBD）.Conclusion The delayed bile leakage after LC is mainly caused by the electric burn of bile duct and aberrant bile duct.Re-operation and peritoneal drainage are simple,safe and effective in the treatment of delayed bile leakage after LC.

关 键 词：腹腔镜 胆囊切除术 迟发性胆漏 术后并发症 

分 类 号：R657.4[医药卫生—外科学]