摘要
目的探讨胆囊外膜下处理胆囊动脉在腹腔镜胆囊切除(LC)术中应用的临床意义。方法对2007年7月至2012年7月183例LC术中胆囊外膜下处理胆囊动脉的临床资料进行总结分析。胆囊动脉的处理:电钩电凝103例,钛夹60例,超声刀处理5例,15例胆囊动脉与胆囊管伴行处理上胆囊动脉与胆囊管一并用Hem-o-Lok夹闭。结果 183例LC成功180例(98.36%),中转剖腹手术3例(1.64%),2例(1.09%)术后残留胆总管远端小结石.术中解剖Calot三角内胆囊动脉至肝右动脉45例,余138例仅解剖其分支,未追求其来源。无胆管和血管损伤等严重并发症发生,无手术死亡病例,全组病人均恢复良好。结论 LC术中应胆囊外膜下处理胆囊动脉的方法可有效防止胆管和血管损伤,更符合安全、微创的理念,是一种合理的手术方式,值得在临床推广。
Objective To explore the clinical significance of application of the way of subserosal cut off cystic artery on laparoscopic cholecystectomy. Methods Analyzing the clinical data of 183 cases of subserosal cut off cystic artery branch method during operation from July,2007 to July,2012. Treatment of the cystic artery included coagulation hook in 103 cases, titanium clip in 60 case, ultrasonic Scalpel in 5 and clip with Hem-o-Lok in 15cases in which the cysticartery lined with the cystic duct was clipped together with the lined cystic duct. Results 181 （98. 36% ）casessucceed ;2 cases （ 1.64% ）are transferred to open surgery;2 cases （ 1.09% ）remain stones of distal choledoch;In these 183cases the cystic artery were separated to the right hepatic artery in 45 and the other 138 were only dealed with the branches of cystic artery. No such complication astrauma of bile duct and vein occurs ; No operative mortality occurs. Conclusion Subserosal treatment of cystic artery for laparoscopic cholecystectomy effectively prevents trauma of bile duct and vein. It is more consistent with the concept ofsecurity and minimal invasion and it worth being recommend as a promising technigue for the operation.
出处
《肝胆外科杂志》
2013年第2期103-105,共3页
Journal of Hepatobiliary Surgery
关键词
腹腔镜胆囊切除术
胆囊动脉
外膜
laparosco pic cholecystectomy
Cystic arte
Subserosal
