摘要
目的探讨经内镜逆行胆管造影(endoscopic retrograde cholangiography,ERC)及鼻胆管引流在腹腔镜胆囊切除(laparoscopic cholecystectomy,LC)术后胆漏处理中的应用价值。方法 2004年1月～2010年12月,对16例LC术后胆漏及早应用ERC检查,了解胆漏的部位、程度、类型。根据具体情况采用鼻胆管引流配合腹腔穿刺置管引流或剖腹探查。结果 ERC检查显示胆管损伤ⅠA型7例,ⅡA型6例,ⅢD型3例。11例行鼻胆管引流7～20 d,2例单纯腹腔引流7、11 d,胆漏愈合;3例肝门部胆管空肠吻合,痊愈出院。16例随访3个月～3年,中位时间1年3个月,无腹痛、发热、黄疸及其他并发症。结论 ERC及鼻胆管引流是LC术后胆漏的简便、准确、微创的诊断和处理方法。
Objective To investigate the effect of endoscopic retrograde cholangiography（ERC） and endoscopic nasobiliary drainage（ENBD） in the treatment of biliary leakage after laparoscopic cholecystectomy（LC）. Methods ERC was used in 16 patients with post-LC biliary leakage in an early stage from January 2004 to December 2010,to determine the location,extent,and type of the leakage.ERC combined with ENBD or abdominal exploration was then carried out accordingly. Results ERC showed type ⅠA biliary injury in 7 cases,type ⅡA in 6,and type ⅢD in 3.ENBD was used in 11 patients for 7 to 20 days,and simple abdominal drainage was carried out in 2 cases,and was not withdrawn until the leakage was healed in 7 and 11 days respectively.Hepaticojejunostomy was performed on 3 patients,who were then cured and discharged from hospital.A median of 15-month follow-up was achieved in the patients（3 months to 3 years）,during which no abdominal pain,fever,jaundice,nor other complications occurred. Conclusion ERC and ENBD is an effective,simple and accurate method for diagnosing and managing biliary leakage.
出处
《中国微创外科杂志》
CSCD
2012年第1期38-39,共2页
Chinese Journal of Minimally Invasive Surgery
关键词
内镜逆行胆管造影
腹腔镜胆囊切除
术后胆漏
胆管损伤
Endoscopic retrograde cholangiography（ERC）
Laparoscopic cholecystectomy（LC）
Postoperative biliary leakage
Bile duct injury
