小切口胆囊切除术致胆道损伤的临床分析（附五例报告）

目的探讨小切口胆囊切除术致胆道损伤的原因及其预防措施和处理方法。方法选择948例行小切口胆囊切除术患者，发生胆道损伤5例，回顾性分析其临床资料。结果5例施行修补手术的患者，T管支撑时间为0．5～1a，拔管前胆道造影没有狭窄现象，拔管后无胆漏及梗阻性黄疸。5例患者均获得随访，随访时间为2～10a，无死亡，术后效果良好。结论小切口胆囊切除术虽具有切口小、恢复快、术后瘢痕小、费用低等优点，但是如果处理不当也会造成严重的胆道损伤。只要术者严格把握好手术适应征，仔细、规范操作，就可以减少胆道损伤；术后及时发现并妥善处理是减轻患者痛苦的关键。

Clinical analysis of minor-incision cholecystectomy induce bile duct injuries(report for 5 cases)

Objective To explore the causes, preventive measure and dispose ways in minor-incision cholecystectomy induce bile duct injuries. Methods 948 patients who performed minorincision cholecystectomy were choosed, and 5 cases were caused bile duct injuries by minor-incision cholecystectomy, to retrospectively analyzed their clinical data. Results 5 patients with bile duct injuries, 1 case was small choledochus by congenital, 1 case was anomalies of biliary system, 2 cases were Mirizz syndrome, 1 case was chronic cholecystitis with gall stone, no case had gone against the operative procedure. 4 cases were timely found in surgical operation, and after discover for 1 cases. All patients with bile duct injuries payed the repair operation, no case need to repair again, no death, had better effects. Conclusion The minor-incision cholecystectomy has advantages of minor-incision, comeback fast, small scar and low cost. But it still can cause bad serious bile duct injuries, if you do it with misconduct. So the surgery doctor should pay more attention to the indication,carefulness and correctness in the operation, so as to reduce bile duct injuries,early discovering after operation and dealing with the suitable way are the key points to get the patients'pain lower and lower.