腹腔镜胆囊切除术胆管损伤的原因及其防治

目的探讨腹腔镜胆囊切除术胆管损伤的原因及其防治方法。方法回顾分析2102例腹腔镜胆囊切除术中胆管损伤病人的临床资料。结果5例胆管损伤经早期发现、早期诊断、及时处理、支撑引流而治愈。3例发现较晚，外引流，后期胆肠Roux—en—Y吻合术治愈。结论严格掌握腹腔镜胆囊切除术手术适应证，熟练掌握操作技术，术中出现问题及时开腹手术是减少胆管损伤的重要因素。胆管损伤早发现，早期修补损伤，胆管支撑管引流，胆管损伤发现较晚和迟发性损伤采用先外引流，二期胆管Roux—en—Y吻合术是可靠的方法。

Reasons of bile duct trauma and its pretection and treatment in the lapsroscopic cholecystectomy

Objective To explore the reasons of bile duct trauma and the ways of prevention and treatment in the lapsroscopic cholecystectomy(LC). Methods The clinical data of 2102 cases of bile duct trauma in the LC were analyzed retrospectively. Results Five cases receiving early diagnose and treatment cured by supportive drainage. Three cases diagnosed lately received outside drainage and cured by Roux-en-Y anastomosis later. Conclusions Mastering the indication of an LC, skilful managment timely laparotomy in the operation are essential points to reduce bile duct traumass. If bile duct trauma can be timely diagnosed, repare and supportive drainage should be used. But if bile duct trauma was diagnosed lately or occurred in the later peroid, outside drainage should be adopted first, and then, the Roux-en-Y anastomosis can be used as a dependable way.