腹腔镜胆囊切除术中胆管损伤常见原因及对策探讨  

Common Causes and Countermeasures of Bile Duct Injury during Laparoscopic Cholecystectomy

作　　者：关养时[1] 陈旭辉[1] 

机构地区：[1]深圳大学附属罗湖医院,广东深圳518000

出　　处：《中国医学创新》2016年第22期101-103,共3页Medical Innovation of China

基　　金：广东省卫生和计划生育委员会课题(A2014513)

摘　　要：目的:对腹腔镜胆囊切除手术中胆管损伤的主要原因进行分析,同时提出相应的解决策略。方法:选取2002年4月-2016年4月于本院进行腹腔镜胆囊切除术治疗并发胆管损伤的20例患者作为研究对象,按照Strasberg分型和临床资料进行分类,将5例患者于手术中发现胆道损伤并及时进行处理作为研究组,15例患者择期进行处理作为常规组,比较两组患者临床治疗效果。结果:研究组无患者发生胆管炎,常规组胆管炎发生率为53.33%,研究组明显低于常规组,比较差异有统计学意义(P<0.05)。结论:局部粘连与胆管变异是导致胆管发生损伤的关键性原因,因此需要按照术中的及时诊断和损伤类型进行处理,保证手术治疗效果,修复胆管损伤情况。Objective： To analyze the main causes of bile duct injury during laparoscopic cholecystectomy and propose the corresponding solutions.Method： From April 2002 to April 2016, 20 cases of bile duct injury treated by laparoscopic eholecystectomy in our hospital were selected as the research subjects, they were classified according to Strasberg classification and clinical data, the bile duct injury was found in 5 cases and was treated in time as the research group, 15 cases selective treatment were treated as the routine group, the clinical therapeutic effect of the two groups were compared.Result： The research group had no angiocholitis occurrence, the routine group cholangitis incidence rate was 53.33%, the research group was significantly lower than routine group, the difference was statistically significant （ P〈0.05 ） .Conclusion： Local adhesion and bile duct variation are the key causes of bile duct injury, therefore, prompt diagnosis and type of injury should be timely processed in accordance with the procedure to ensure the effect of surgical treatment and repair of bile duct injury.

关 键 词：腹腔镜 胆囊切除术 胆管损伤 对策 

分 类 号：R657.4[医药卫生—外科学]