摘要
目的 总结临床经验 ,有效降低腹腔镜胆囊切除术 (LC)严重并发症。方法 分析10 19例LC中出现严重并发症的原因和处理方法。结果 注意操作规范可望降低胆管损伤、术中术后出血、胆漏等并发症的发生。结论 为减少误伤胆总管须注意 :1.分离胆囊管前 ,先将Calot三角的前后浆膜及粘连充分剪开 ,并清除三角内的结缔组织 ,使胆囊管、胆囊动脉骨骼化。 2 .尽可能显露胆囊管、胆总管、肝总管汇合部后再剪断胆囊管。 3.当分离解剖Calot三角时发现其内直行血管较正常多时 ,应警惕是否已在胆总管左侧操作。 4.在横断胆囊管前应用内镜从胆囊后方、上方、前方各个角度再次确认解剖关系。当解剖不清时宜充分解剖Calot三角 。
Objective Summarization of clinical experiences to decrease effectively laparoscopic choleeystectomy (LC) complications Methods 1019 patients were divided into three groups:early phase group,metaphase group and late phase group.Compare occurrence rate of complications:bile duct injury,bleeding intraoperative and postoperative,biliary leakage among the three groups.Result The rate of complications in earlyphase group,metaphase group and latephase group were 2 75%,0 92% and 0 69% respectively.The complications in earlyphase group was significantly higher than those of the other two groups.Conclusion In order to decrease operative injuries of the common bile duct,attention should be paid to:1.Meticulous dissection of the serosa and adhesion of the Calot’s triangle so as to skeletonize the cystic duct and cystic artery;2.Clear exposure of the three ducts:cystic duct,common duct and hepatic duct;3.Confinement of the dissection right to the common bile duct;4.Identification de novo the three ducts before severing the cystic duct.Intraoperative cholangiography can not only prevent residual gallstones of common duct but also expose biliary tract system and prevent bile duct injury.
出处
《江苏医药》
CAS
CSCD
2000年第7期522-523,共2页
Jiangsu Medical Journal
关键词
腹腔镜胆囊切除术
并发症
防治
Laparoscopic cholecystectomy complications Prevention Treatment
