腹腔镜胆囊切除术并发胆漏的原因及防治  

The causes and prevention of bile leakage caused by laparoscopic cholecystectomy

作　　者：李培生[1] 周少波[1] 贲大刚[1] 程凯[1] 

机构地区：[1]蚌埠医学院第二附属医院普外科,安徽蚌埠233040

出　　处：《蚌埠医学院学报》2012年第8期896-897,共2页Journal of Bengbu Medical College

摘　　要：目的:探讨腹腔镜胆囊切除术并发胆漏的原因和防治方法。方法:对8例腹腔镜胆囊切除术并发胆漏患者的临床资料进行分析。结果:术后早期胆漏6例,系胆囊床毛细胆管或迷走胆管损伤所致,经腹腔引流和药物治疗治愈;迟发性胆漏2例,1例漏口位于肝总管,1例位于右肝管,2例经漏口修补+T管胆道引流治愈,随访6个月至2年无胆管炎发作且无胆管狭窄。结论:肝外胆管、迷走胆管损伤是腹腔镜胆囊切除术后胆漏的主要原因,建立通畅的腹腔引流,修补损伤胆管、T管支撑引流是治疗腹腔镜胆囊切除术后胆漏、预防并发症出现的主要方法。Objective：To investigate the causes and treatment of bile leakage caused by laparoscopic cholecystectomy （LC）. Methods ： The clinical data of 8 cases with bile leakage caused by LC were retrospectively analyzed. Results： Six cases with bile leakage caused by aberrant bile duct or cholangiole injuries were cured with abdominal cavity drainage and drugs. Two cases with late-occurred bile leakage including 1 case opening in common hepatic duct and 1 case opening in right hepatic duct were cured by opening repair and T-tube drainage. No cholangitis and bile duct stenosis were found during following-up for 6 months to 2 years. Conclusions： Extrahepatic bile duct and aberrant bile duct injuries were the most common reasons of bile leakage after LC. Abdominal cavity drainage,bile duct repair and T-tube drainage are the main methods to treat bile leakage after LC and prevent comphcations.

关 键 词：胆囊切除术 腹腔镜术 胆漏 

分 类 号：R657.4[医药卫生—外科学] R572[医药卫生—临床医学]