摘要
目的探讨腹腔镜胆囊切除术中胆管损伤的特点、相应的处理方法,并为减少这类损伤提出相应的预防措施。方法回顾性分析近12年我科行腹腔镜胆囊切除术3134例,12例发生胆管损伤;经手术修复,并随访1～12年。结果12例胆管损伤分别为胆总管撕裂伤1例,右肝管电灼伤1例,肝总管电灼伤2例,胆总管横断伤2例,肝总管纵向损伤1例,胆囊管残端漏2例,胆漏3例分别采用相应的处理方法,修复胆管损伤。结论术中应尽可能地分辨Calot三角的局部解剖,减少此部位的电烧操作,对于胆管损伤应争取术中及早发现,Ⅰ期处理。胆道修复后T管的支撑时间应足够长,特别是对胆道缺损较大,采用带蒂组织瓣修复时更应如此。
Objective To investigate the features and management of bile duct injury caused by laparoscopic cholecystectomy to provide evidence for its prevention. Methods The clinical data of 12 patients with bile duct injury caused by the laparoscopic cholecystectomy treated in our hospital from July 1991 to December 2003 were retrospectively analyzed. Results All the 12 patients recovered well and no biliary stricture occurred during the follow-up for 1 12 years. Conclusions Anatomy and pathology of the bile duct and doctor＇s skill are all crucial points for preventing the bile duct injury during laparoscopic cholescystectomy. The T tube should be remained in the bile duct for 1 or more than 1 year to repair the bile duct.
出处
《中华肝胆外科杂志》
CAS
CSCD
2005年第9期593-595,共3页
Chinese Journal of Hepatobiliary Surgery
