腹腔镜胆囊切除术胆管损伤及术后胆漏的临床分析

目的 分析腹腔镜胆囊切除术后胆漏及胆管损伤的原因、治疗方法及预后。方法 总结1999年1月～2005年7月7例腹腔镜术后胆漏及胆管损伤的患者，进行回顾性分析。结果 7例患者中2例迷走胆管漏，1例经腹腔引流后治愈，1例经B超引导穿刺引流后治愈；胆囊管残端漏1例，再次手术缝扎，胆总管探查取石放置T型管引流后治愈，肝总管损伤漏2例，1例用3-0可吸收线间断缝合，放置腹腔引流治愈，1例剖腹手术修补漏口，放置T型管支撑6个月；胆总管横断2例剖腹行胆总管端端吻合放置T管支撑6-7个月。术后随访1～3年，均恢复良好。结论 腹腔镜胆囊切除术后的胆漏及胆管损伤，应及时发现，正确处理。

Analysis of 7 cases of bile leakage and bile duct injury in laparoscopic cholecystectomy

Objective To analyze the cause of bile leakage and bile duct injury of laparoscopic cholecystectomy,and to discuss its treatment methods and prognosis. Methods 7 cases of bile leakage and bile duct injury of laparoscopy cholecystectomy between Jan. 1999 and Jul. 2005 retrospectively qnalyzed. Results In 7 cases, the mini - bile duct leakage were 2. One of these group was cured by placed the belly cavity drainage. The other was cured by percutaneously punctured catheterizing drainage had been guided by B - ultrasonic wave. The cystic duct leakage was 1 case,this case was sewed up the leak of the cystic duct and examined the common bile duct and placed T type tube to drain bile for 4 - 6 months. The common hepatic duct leakage were 2 cases,one was sewed up the leakage of common hepatic duct and placed type T tube to drainage bile for 6 months. The other was sewed up the leakage of common by 3 - 0 absorbent lines and placed the belly cavity drainage. The common bile duct were cut 2 cases,in which 2 cases were operated bile duct and bile duct anastomosis,placed type tube to drain bile for 6 months. All cases were followed - up for 1 - 3 years. All cases were good curative effect. Conclusion The bile leakage and the bile duct injury of laparoscopic cholecystectomy should be discovered on time. treated exactly.