摘要
目的 研究腹腔镜胆囊切除术 (laparoscopiccholecystectomy ,LC)中胆囊管和胆囊动脉的正常解剖及变异 ,旨在选用恰当的手术方法正确处理 ,提高LC手术的质量 ,减少并发症。方法 LC手术 12 0例 ,术前经过肝胆超声检查 ,口服加静脉胆管造影选择 ,排除肝外胆管结石病例 ,在气管插管全麻下 ,人工CO2 气腹 ,采用顺行或逆行法游离胆囊 ,认清“三管”的关系 ,安全钳夹后剪断胆囊管。提高对变异胆囊动脉的处理水平 ,可减少意外的紧急出血。结果 LC手术 12 0例 ,胆囊管变异 38例 ,胆囊动脉变异 2 1例 ,LC中转手术 9例 ,全组发生 1例胆总管损伤 ,4天后经开腹胆肠内引流治愈。结论 LC术中对异常胆囊管和胆囊动脉的认识和处理水平 ,对提高手术质量 ,减少并发症具有非常重要的意义。
Objective By researching into the normal anatomy and variant of cystic duct and artery during laparoscopic cholecystectomy (LC) , to choose a proper survey method to ensure surgical quality and to lessen complications in LC . Method Among 120 LC cases, through preoperative ultrasonography of liver and gallbladder, oral ingestional and veinal cholecystography, some cases of extrahepatic bile duct caculous were excluded . Aided with artificial CO -2 pneumoperitioneum under tracheal intubation general anaesthesia , gallbladder was dissociated by anterograde or regression method . Then the cystic duct was held by forceps and cut after confirming the relationship of the 'three-ducts'. Improved technique to treat variant cystic artery may lessen accidental bleeding . Result Among 120 cases-38 cases of cystic duct variant, 21 cases of cystic artery variant, 9 cases of LC to Open Cholecystectomy (OC)-1 ductus-communis injury in LC was cured after it was enforced Roux-en-y Choledocho-jejunostomy 4 days later. Conclusion Improving the level of cognition and treating of cystic duct and cystic artery is very important to promoting operation quality and decreasing complications.
出处
《皖南医学院学报》
CAS
2001年第4期264-265,267,共3页
Journal of Wannan Medical College