胆囊淋巴结在腹腔镜胆囊切除术中的定位标志作用初探  

Study of Cystic Lymph Node as A Location Sign in Laparoscopic Cholecystectomy

作　　者：张伟耀[1] 饶智[2] 潘磊[2] 

机构地区：[1]南方医科大学附属小榄医院普外科,广东中山528415 [2]新疆生产建设兵团第三师医院普外科,新疆喀什844000

出　　处：《中国普外基础与临床杂志》2014年第9期1134-1137,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的初步探讨肿大淋巴结在腹腔镜胆囊切除术中的定位价值。方法回顾性分析2010年10月至2013年10月期间在南方医科大学附属小榄医院及新疆生产建设兵团第三师医院行腹腔镜胆囊切除术的100患者的临床资料,分析肿大淋巴结与胆囊动脉、胆囊管及肝门板的位置关系。结果 100例患者中,发现明确淋巴结81例（81.0%）,其中发现1个淋巴结76例（76.0%）,发现多个淋巴结5例（5.0%）;未发现明确淋巴结19例（19.0%）。76例发现单个肿大淋巴结的患者中,淋巴结位于胆囊动脉前支上方48例,位于胆囊动脉前支下方21例,紧邻胆囊动脉后支7例。所有患者均顺利完成手术,其中中转开腹3例。手术时间25～116 min、（43.0±6.5）min;术后住院时间2～6 d、（3.0±0.6）d;术后无胆汁漏、胆管损伤等严重并发症发生,无死亡,均治愈出院。结论淋巴结在胆囊三角内的位置相对固定,其可协助指引术者研判和解剖肝门区域各组织结构,对术中确认胆囊动脉和胆囊管及预防副损伤具有较大的参考意义。Objective To explore the value for localization of cystic lymph node in laparoscopic cholecystectomy.Methods Clinical data of 100 cases who underwent laparoscopic cholecystectomy in Affiliated Hospital of Southern Medical University and The Third Division Hospital of Xinjiang Production and Construction Corps were collected to analyze retrospectively, for exploring the relationship of localization of cystic lymph node, cystic artery, cystic duct, and liver door. Results Of the 100 cases, 81 cases（81.0%） were found lymph node, in which 76 cases（76.0%）were found 1 lymph node and 5 cases（5.0%） were found lymph node more than 1, the other 19 cases（19.0%） were not found lymph node. Of the 76 cases who were found only 1 lymph node, lymph nodes were located above the anterior branch of cystic artery in 48 cases, below the anterior branch of cystic artery in 21 cases, and adjacent to the posterior branch of cystic artery in 7 cases. The operation was successful in all patients without death, of which 3 cases were transferred to laparotomy. The operation time were（43.0±6.5） min（25-116 min）, and hospital stay after operation were（3.0±0.6） days（2-6 days）. No serious complications of bile leakage, bile duct injury, and death happened after operation, and all cases were cured and discharged. Conclusions Cystic lymph node in the calot triangle is in relatively fixed position of laparoscopic cholecystectomy, it can help to guide judging anatomical hepatic portal region of each organization structure, and can to confirm the location of cystic artery and cystic duct, which is helpful to prevent injury during the operation of laparoscopic cholecystectomy.

关 键 词：胆囊淋巴结 腹腔镜胆囊切除术 定位 胆囊动脉 胆囊管 

分 类 号：R657.4[医药卫生—外科学]