腹腔镜胆囊切除术合并胆道损伤的原因及对策

目的　探讨腹腔镜胆囊切除术(L C)胆道损伤的原因、预防及对策。方法　总结肝胆肠外科研究中心4 86 3例L C的经验,结合文献进行回顾性分析。结果　4 86 3例L C中发生胆道损伤8例,其中肝胆管横断伤6例,肝总管撕裂伤及胆管电灼伤各1例。结论　L C胆道损伤的预防是关键。损伤的处理应根据发生的时间、部位及程度等选择不同的方法,及时发现,正确处理,常可取得较好结果并防止更严重并发症的发生。

Cause and strategy of bile duct injury in laparoscopic cholecystectomy

Objective To investigate the cause and prophylactic-therapeutic strategy of bile duct injury in laparoscopic cholecystectomy(LC).Methods A retrospective study was performed by summarizing the experience of 4863 patients underwent LC and the literature was reviewed.Results There were eight patients complicated with bile duct injury in 4863 patients treated with LC, including 6 cases of transection injury of bile duct,one case of rupture injury of common bile duct and electric burn of bile duct.Conclusion Prevention of bile duct injury plays a role in LC,the duct injury should be treated according to the time,location and degree.Good result may be obtained and serious complications may be prevented by timely find and right management.