腹腔镜胆囊切除术后黄疸的处理及分析  

Treatment and Analysis of Jaundice After Laparoscopic Cholecystectomy

作　　者：王怀志[1] 苑军正[1] 汪海[1] 石献洲[1] 

机构地区：[1]武警河南总队医院普外科,郑州450052

出　　处：《中国微创外科杂志》2016年第12期1140-1142,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜胆囊切除（laparoscopic cholecystectomy,LC）术后黄疸的原因及处理方法。方法回顾性分析2010年3月-2015年3月51例LC术后黄疸的临床资料,以超声、CT、磁共振胰胆管造影或经内镜逆行胰胆管造影诊断,其中胆总管结石残留35例,胆总管损伤11例,肝细胞性黄疸2例,十二指肠乳头出口狭窄3例（炎性狭窄2例,十二指肠乳头腺癌1例）,采用十二指肠镜下取石27例,十二指肠镜下造影或活检4例,腹腔镜手术3例,开腹手术17例。结果 51例手术均成功,术后10-15 d出院,无死亡病例。结论 LC术后黄疸原因较多,在诊断过程中,应结合病人具体情况,分析具体原因,采用个体化处理。Objective To investigate the causes and treatment of jaundice after laparoscopic cholecystectomy（ LC）.Methods Clinical data of 51 patients with jaundice after LC from March 2010 to March 2015 were retrospectively analyzed in our hospital. According to the diagnosis of ultrasound, CT scanning, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography,there were 35 cases of residual common bile duct stones,11 cases of common bile duct injury,2 cases of hepatocellular jaundice, 3 cases of duodenal papilla outlet stenosis（ inflammatory stenosis in 2 cases and duodenal papilla adenocarcinoma in 1 case）. Treatment included 27 cases of duodenal endoscopy,4 cases of duodenal endoscopy or biopsy,3 cases of laparoscopic operation and 17 cases of open surgery. Results The operations were performed successfully in all the 51 cases. The patients were discharged from hospital at 10- 15 postoperative days. No fatal case happened. Conclusions Reasons of jaundice after LC are different. It is necessary to analyze and deal with individual case. We should combine and analyze with the specific circumstances in the process of diagnosis.

关 键 词：腹腔镜胆囊切除术 黄疸 并发症 

分 类 号：R657.4[医药卫生—外科学]