摘要
目的：探讨腹腔镜胆囊切除术（Laparoscopic Cholecystectomy， LC）中胆道并发症的预防及治疗。方法我院在2005年3月～2013年12月所做的3000例LC手术中，其中有6例（包括外院转入1例）胆道损伤的患者，选取这些患者作为研究对象。结果7例患者右肝管夹闭1例，二次手术，去除钛夹，痊愈出院，胆总管成角部分夹闭1例，术后延迟黄疸，二次手术探查，去除钛夹缝扎胆囊管，胆道探查，“T”管引流3个月，痊愈，胆总管横断1例，肝总管横断2例，均术中发现行胆总管原位吻合，“T”管引流6个月，痊愈，肝总管横断均行胆肠吻合术Roux-en-y吻合口放置支架引流3个月痊愈，左右肝管全部清扫断，术后胆汁性腹膜炎，二次手术行肝门部胆管空肠盆式吻合1例。结论胆道损伤分主观原因和客观原因，主观上的大意及解剖的变异是LC导致胆道损伤的常见原因，胆道损伤重在预防，及时发现，尽早处理才能获得满意的预后。
Objective To investigate the prevention and treatment of biliary complications duing laparoscopic cholecystectomy （LC）. Methods During March 2005 to December 2013, there were 3 000 cases of LC surgery conducted in our hospital, among them, 6 cases had biliary injury and were taken as the research object. Results In 6 patients, 1 case had right hepatic tube clip and was taken secondary surgery to remove titanium clamp, recovery angles bravery clip happened in 1 case, postoperative delayed jaundice, and was taken secondary surgery to remove the titanium crack cystic duct, biliary tract probe, the＆quot;T＆quot;tube drainage for 3 months. Common bile duct transection happened in 1 case. 2 cases had hepatic duct transection, and the current common bile duct anastomosis in situ, the＆quot;T＆quot;tube drainage for six month. Hepatic duct transection were biliary intestinal anastomosis Roux en-y anastomotic stent drainage, 3 months left and right hepatic duct cleaning off entirely, postoperative bile peritonitis, secondary surgical resection of the hepatic door bile duct jejunum tub of 1 case. Conclusion There are subjective reasons and objective reasons for biliary injury, prevention measures, timely detection and early treatment can achieve a satisfactory outcome.
出处
《中国继续医学教育》
2015年第4期109-109,共1页
China Continuing Medical Education
关键词
腹腔镜
胆囊切除术
胆道损伤
Laparoscopic
Cholecystectomy
Biliary injury
