摘要
报告胆囊切除术后胆汁漏25例，主要原因为肝外胆管、副肝管、迷走胆管损伤，肝外胆管微小破口，胆囊管结扎不完善，胆总管探查T管旁或缝合胆管的针眼漏。预防措施：主要是避免胆管损伤，完善处理胆囊管，迷走胆管和细小的副肝管可以结扎，关胸前仔细检查手术野。术后胆汁漏、行ERCP检查，有助于明确部位和原因。胆漏并腹膜炎、疑有胆管损伤、胆囊管残端漏或肝下大量积液、应及时开腹再手术。
This article reports the bile leakage after cholecystectomy in 25 cases. The maincauses are:injuries of the accessorybile or aberrant hepatic duct,the minute broken opening of the extrahepatic ducts non-fitting ligated cholecystic duct and the needle hole suturing common bile duct putting on 'T' tube. The Preventive methods are:preventing injury of the common bile duct,fitting cholecystic duct,ligating the minute aberrant hepatic duct,and examining the operative area before the closure of the abdominalcavity. ERCP can help locate the position and diagnose causes of the bile leakage after the operation. An immediate reoperationshould be performed to overcome the bile leakage complicated acute peritonitis,the suspected bile duct injury,the leakage of thecholecystic duct,stump,or much collection of the inferiohepatie space.
出处
《肝胆外科杂志》
1998年第3期147-148,共2页
Journal of Hepatobiliary Surgery
关键词
胆囊切除
胆汁漏
胆管损伤
预防
Cholecystectomy Bile leakage Bile duct injury
