腹腔镜胆囊切除术中粗大胆囊管处理体会  

Management of large cystic duct during laparoscopic cholecystectomy

作　　者：方哲平[1] 董米连[1] 朱正练[1] 彭淑牖[2] 

机构地区：[1]浙江省台州医院微创外科中心,临海317000 [2]浙江大学附属第二医院,杭州310009

出　　处：《中国微创外科杂志》2003年第1期67-68,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨腹腔镜胆囊切除术中粗大胆囊管的处理方法。　方法　回顾分析 1995年 5月～ 2 0 0 1年 12月我院 10 5 2例LC中 2 4例粗大胆囊管的临床资料 ,其中胆囊管 (0 4～ 0 6 )cm 12例 ,(0 6～0 8)cm 8例 ,(0 8～ 1 0 )cm 2例 ,>1cm 2例。分别采用二夹法 (10例 ) ,三夹法 (5例 ) ,梯形钳夹法 (6例 ) ,旋转钳夹法 (3例 )处理。　结果　 2 1例顺利完成LC ,3例因术中出血中转开腹。全组无胆漏、膈下积液发生。　结论　腹腔镜胆囊切除术中粗大胆囊管采取不同方法处理可顺利完成LC。Objective To investigate the management of large cystic duct during laparoscopic cholecystectomy(LC). Methods 24 out of 1052 patients, whose cystic duct size in diameter are larger than 0.4cm, were reviewed retrospectively from March 1995 to December 2001. The diameter of cystic duct is 0 4cm～0 6 cm in 12 cases, 0 6cm～0 8cm in 8 ones, 0 8cm～1 0cm in 2 ones and larger than 1cm in 2 ones. Different methods were adopted. Two-clip method was used in 10 cases, three-clip method in 5 ones, ladder clip method in 6 ones and rotation clip method in 3 ones. Results LC was completed successfully in 21 cases. 3 cases were converted to open cholecystectomy due to blood loss. No complications such as bile leakage and subphrenic abscess occurred. Conclusions Large cystic duct during LC can be managed successfully by different methods.

关 键 词：腹腔镜胆囊切除术 粗大胆囊管 二夹法 三夹法 梯形钳夹法 旋转钳夹法 

分 类 号：R657.4[医药卫生—外科学]