摘要
目的 :降低电视腹腔镜胆囊切除术 (LC)胆漏的发生率 ,提高治愈率 ,防止胆漏对病人的危害 ,促进愈合。方法 :分析 1991年 12月～ 1998年 12月我院开展LC40 0 0例 ,出现胆漏 2 9例的原因 ,用线扎代替钛夹处理胆囊管和胆囊血管 ,简化了胆囊三角的过多解剖 ;术中针对性的置放引流管防止胆汁性腹膜炎 ;特殊情况的胆囊作特殊处理。结果 :拓宽了LC的适应范围 ,大大减少了手术中胆管的损伤、出血。发生胆漏的病人中有 41%(12 / 2 9)因术中置管引流而未出现胆汁性腹膜炎 ,并很快康复。术后B超动态观察胆囊窝积液情况 ,及时引流 ,胆漏多能自愈。结论 :熟练的操作技巧能避免手术损伤 ,认真线扎处理胆囊管和胆囊血管并针对性置放引流管 ,能有效防止胆漏和胆汁性腹膜炎 ;及时发现、及时处理是减少胆漏危害的关键。
Objective:To decrease the incidence rates of biliary fistula,increase the curative rates,ease the patient′s suffering caused by the complication,and to promote a cure.Methods: 29 of 4000 cases treated by LC suffered from diliary fistula in our hospital from december 1992 to 1998.We dealt with bile ducts and vessels by ligation with silk suture instead of titanium forceps.Drainage tubes were placed for draining in order to prevent biliary peritonitis.The neck of gallbladder was not ligated in special condition.Results: Injuries and bleeding were decreased during the operation 41% of the cases did not suffer from peritonitis caused by bile fistula for the drainage tubes were placed while the operation was performed.Frequent ultrasonic examination was applied to the patients after the operation.Thus,the hydrops of fossa vesicae felleae was drained in time.Most of the patients with bile fistula were cured.Conclusion: Bile fistula and biliary peritonitis can be well prevented if silk suture is used for ligation of bile ducts and vessels and drainage tubes are placed according to requirement.It is very important for decreasing of damage caused by bile fistula to find and treat the risk in time.
出处
《中国厂矿医学》
2001年第2期91-92,共2页
Chinese Medicine of Factory and Mine
关键词
电视腹腔镜
胆漏
引流
预防
LC biliary fistula Ligation Drainage tube
