腹腔镜胆囊切除术胆管损伤的防治

目的探讨腹腔镜胆囊切除术（Laparoscopic cholecystectomy,LC）胆管损伤发生的原因、诊断及处理方法.方法回顾性分析我院收治的12例LC胆管损伤的临床资料.结果本组病例中LC术中发现2例立即中转开腹手术,术后早期发现10例行再次开腹手术.其中,胆总管横断伤7例,胆总管和肝总管部分损伤3例,右肝管损伤2例.全部病例均痊愈出院,无严重并发症发生.结论腹腔镜胆囊切除术胆管损伤的发生主要与解剖病理及操作技术有关,早期发现、及时恰当再手术是改善预后的关键.

Prevention and Management of Bile Duct Injury in Laparoscopic Cholecystectomy

Objective To analyze the causes, diagnosis and management of biliary tract injury in laparoscopic cholecystectomy. Methods Clinical materials of 12 cases with bile duct injury were summarized retrospectively. Results In 12 patients,2 cases were found during operation and were conveyed from LC to open operation to repair the injuries. 10 cases were diagnosed in early postoperation period, and were re -operated by open operation. The complications included common bile duct transaction injury in 7 cases, partly injuring of common bile duct and common hepatic duct in 3 cases and right hepatic duct injury in 2 cases. All cases were cured and had no severe complication. Conclusion The occurrence of bile duct injury in LC is related to anatomy, pathology and operation. Timely and adequate reoperation is the key to survival and good outcome.