腹腔镜胆囊切除术胆管损伤的因素及对策

目的:通过对腹腔镜胆囊切除术(laparoscop ic cholecystectomy,LC)胆管损伤因素的探讨,找准其预防对策,减少胆管损伤率。方法:回顾性分析我院1992年10月~2004年8月实施的35 000例LC术中29例胆管损伤的因素。结果:胆总管损伤11例;汇合部分离性损伤6例;穿孔性胆管损伤9例;右侧副肝管损伤3例。29例全部治愈,27例随访1.5~11年,无严重并发症。结论:LC术中要警惕胆管损伤因素,仔细操作每一步,胆管损伤率可减少。

Causes and treatment of the bile duct injury in laparoscopic cholecystectomy

Objective:To investigate the prevention and treatment measures of the bile duct injury in laparoscopic cholecystectomy.Methods:Retrospectively analyze the causes of 29 cases with bile duct injury among 35 000 patients received laparoscopic cholecystectomy from October 1992 to August 2004. Results:11 cases suffered from the common bile duct injury,and 6 cases combined injury of the junction of the common bile duct and the gallbladder duct.9 cases had perforative bile duct injury,and 3 cases had the right accessary hepatic duct injury.All the 29 patients were cured.In 27 cases followed up for 1.5-11years,no severe complications was found.Conclusions:We should pay attention to the causes of bile duct injury in laparoscopic cholecystectomy and operate carefully,which can reduce the rate of bile duct injury.