摘要
目的：总结腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）胆管损伤术后胆漏的预防与处理。方法：回顾分析2000年1月至2008年6月我院9例LC胆管损伤术后胆漏患者的临床资料，总结胆漏的原因、预防措施及处理。结果：9例全部痊愈出院。随访3～60个月无黄疸、发热等胆管炎症状。结论：LC胆管损伤后胆漏重在预防。肝内胆管分支损伤及肝外胆管侧壁损伤可采取保守治疗，腹腔引流联合内镜治疗明显缩短病程。肝外胆管横断伤需腹腔引流4周，周围炎症基本消退再行肝门胆管盆式空肠内引流术。
Objective：To summarize the prevention and management of bile leakage after bile duet injury in laparoscopic cholecystectomy （LC）. Methods：The clinical data of 9 bile leakage eases out of 4 560 LC procedures performed in our department from Jan. 2000 to Jun. 2008 were retrospectively analyzed. The reason,prevention and management of bile leakage were summarized. Results： Common hepatic duct transection injury in 2 eases retrieved by Roux-en-Y hepaticojejunostomy. One case of injury on common bile duct lateral wall was successfully treated by T-tube drainage. 2 cases of common hepatic duet lateral wall or right hepatic branch duet injury were eured by abdominal cavity drainage combined with ENBD or EST. 4 cases of aberrant bile duct, right hepatic, duet branch or accessory right hepatic duel leakage were cured by drainage fur 7-43 days. All patients were discharged successfully and followed up for 3-60 months with no fever or jaundice. Conclusions： It＇s important to prevent bile injury during LC. lntrahepatic bile branch duet and extrahepatic bile duct lateral wall injury is often cured by conservative abdominal cavity drainage. Hospitalization time can be shortened if abdominal cavity drainage combines with endoscopic treatment. Roux-en-Y hepaticojejunostomy is recommended for extrabepatie bile duet transection injury when drainage lasts fur 4 weeks and peripheral inflammation has regressed.
出处
《腹腔镜外科杂志》
2009年第9期690-693,共4页
Journal of Laparoscopic Surgery
关键词
胆囊切除术
腹腔镜
胆管损伤
胆漏
Choleeysteetomy, laparoseopie
Bile duct injuries
Bile leakage
