腹腔镜胆囊切除术并发胆管损伤分析  

ANALYSIS OF BILE DUCT INJURY DURING LAPAROSCOPIC CHOLECSTECTOMY

作　　者：余耀生[1] 詹银楚[1] 徐集麟[1] 

机构地区：[1]浙江省衢州市人民医院外科,衢州32400

出　　处：《肝胆外科杂志》2003年第4期285-287,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨腹腔镜胆囊切除术 (L C)并发胆管损伤的原因和处理。方法　回顾我院所做的 L C 6 4 8例 ,其中胆管损伤 6例 ,分析损伤原因及治疗效果。结果　电灼胆管穿孔伤 2例 ,修补后痊愈 ,肝总管以下胆管缺失 2 .0 cm 1例 ,行胆肠吻合支撑管留置 9月 ,效果良好 ,肝总管以下胆管缺失 1.5 cm 1例 ,胆管端端吻合后出现反复发热及左肝管结石 ;另 2例胆肠吻合病人支撑管过早脱出 ,出现不同程度胆管狭窄和胆道感染。结论　 L C胆管损伤修复时吻合口应无张力 ,支撑管需可靠持久 ;胆囊病变时 。Objective To investigate the causes and management of bile duct injury derived from laparoscopic cholecystectomy(LC).Methods The followed up data of 648 cases of LC operated in our hospital were retrospectively analyzed.The causes of bile duct injury and the results of treatment were analyzed for 6 cases of LC among them.Result 2 cases of porous biliary injury by electric burn were repaired without complications.One case with 2.0 cm deletion on bile duct below common hepatic duct recovered with encouraging results by deteotion of bracing tube for nine months after choledochojejunostomy.One case with 1.5 cm deletion on bile duct below common hepatic was affliciated with repeated fever and choledith of left hepatic duct after chpleystectomy.Another 2 cases of were found infection of biliary duct and stricture of bile duct with different degree because of early drop of bracing tube.Conclusion No pull on anastomotic stoma and persistently secure bracing tube are two important factors while reparing biliary duct injury during LC.The bile duct injury is inclined to frequent patients with some peculiar anatomicopathological changes.

关 键 词：腹腔镜胆囊切除 胆管损伤 处理 并发症 原因 

分 类 号：R657.4[医药卫生—外科学]