圈套器在腹腔镜胆囊切除术中的应用

目的探讨圈套器在胆囊管增粗或胆囊三角分离困难时腹腔镜胆囊切除术(laparoscopiccholecys-tectomy,LC)中的临床应用及其适应证,优越性和方法。方法腹腔镜胆囊切除术中由于种种原因导致胆囊管部位增粗或与周围组织致密粘连,应用钛夹或可吸收夹不能夹闭或预期不能夹闭时,可应用圈套器行胆囊管部位的结扎。结果249例病人,无1例发生出血、黄疸、胆瘘及胆道损伤,仅有1例发生胆囊管残端残余结石。结论腹腔镜胆囊切除术中因胆囊三角解剖困难,逆行切除胆囊时;或因胆囊管增粗或胆囊管与周围组织致密粘连致不能应用钛夹夹闭时,应用圈套器安全可行,优势明显。

Application of the snare in laparoscopic cholecystectomy

[Objective] To explore the clinical application of snare in laparoscopic cholecystectomy(LC), and its suitability and superiority. [Method] It is suitable to use snare to deal with the enlarged or adhesive cystic duct when it is difficult to use titanium clip or absorbable clip to deal with. [Result] No bleeding, jaundice, biliary leakage, bile duct injury and other complications were occurred except one case of residual concretion in cystic duct in 249 cases. [Conclusion] It is suitable, safe and superior to use snare to deal with the enlarged or adhesive cystic duct in retrograde laparoscopic cholecystectomy when the Calot triangle was dissected hardly.