经脐入路腹腔镜胆总管探查一期缝合术后胆漏34例分析

目的分析经脐入路腹腔镜胆总管探查一期缝合术后胆漏并发症的发生及其治疗，探讨有效的防治措施。方法回顾性分析2008年11月至2013年3月，本院34例经脐入路腹腔镜胆总管探查一期缝合术后发生胆漏并发症患者的临床资料。结果胆漏发生率为22．7％（a4／150）。34例胆漏患者中，22例在术后24h内出现，12例在术后3～7d出现，经腹腔引流34例患者均治愈。结论严格掌握手术适应证，术中操作轻柔，认真仔细缝合胆总管以及加强营养支持等，是防治经脐入路腹腔镜胆总管探查一期缝合术后胆漏的有效措施。

Analysis of bile leakage after primary suture following transumbilical laparoscopic common bile duct exploration in 34 cases

Objective To analyze the bile leakage complication after primary suture following transumbilical laparoscopic common bile duct exploration, and the treatment of bile leakage, to explore its effective control measures. Methods The clinical data of 34 cases of bile leakage patients treated with primary suture after transumbilical laparoscopic common bile duct exploration from Nov. 2008 to Mar. 2013 were retrospective analyzed. Results The bile leakage rate was 22.7% （34/150）, 22 cases occurred within 24 h after surgery, 12 cases occurred in the postoperative 3 - 7 d. All 34 patients after abdominal drainage were cured. Conclusion Strict surgical indications, gentle surgery operation, carefully sutured the common bile duct and nutritional support, etc, which are effective measures of prevention and treatment after bile leakage of primary suture following transumbilical laparoscopic common bile duct exploration.