| 腹腔镜胆总管探查即时缝合术后胆漏的原因及对策 |
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| 引用本文： | 陈安平,赵聪,索运生,陈先林,肖宏,刘安,王征夏.腹腔镜胆总管探查即时缝合术后胆漏的原因及对策[J].肝胆胰外科杂志,2008,20(5):322-324. |
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| 作者姓名： | 陈安平 赵聪 索运生 陈先林 肖宏 刘安 王征夏 |
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| 作者单位： | 成都市第二人民医院,肝胆胰外科,四川,成都,610017 |
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| 摘 要： | 目的分析腹腔镜胆总管探查即时缝合术后胆漏的原因，探讨预防方法及处理措施。方法回顾性分析1992年6月～2007年10月776例腹腔镜胆总管探查即时缝合术后36例胆漏患者的临床资料，、结果胆管切口胆汁渗漏34例，其中经术中常规放置的腹腔引流管引流治愈29例、再次开腹置T管及腹腔引流管引流治愈1例、再次经腹腔镜下置多根腹腔引流管引流治愈1例、再次经腹腔镜下经胆囊管残端置输尿管导管及腹腔引流管引流治愈l例、行内镜鼻胆管引流治愈2例经胆囊管残端放置的输尿管导管脱落而导致胆汁性腹膜炎2例．再次腹腔镜下经胆囊管残端放置输尿管导管及腹腔引流管1例和放置T管及腹腔引流管1例而治愈.结论腹腔镜胆总管探查即时缝合术后胆管切口胆汁渗漏和输尿管导管脱落是胆漏的主要原因．保持或建立通畅的腹腔引流或胆管引流是治疗胆漏的主要处理措施．
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| 关 键 词： | 腹腔镜 胆结石 胆总管探查术 胆漏 |
Causes and measures for bile leakage after primary closure of laparoscopic common bile duct exploration |
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| Institution: | CHEN Anping, ZHAO Cong, SUO Yunsheng, et al. (Department of Hepatopancreatobiliary Surgery, the Second People＇s Hospital of Chendu, Chendu 610017) |
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| Abstract: | Objective To analyze the causes of bile leakage after primary closure of laparoscopic common bile duct exploration (PCLE) and explore the preventive method and management measure. Methods The clinical data of 36 bile leakage cases in 776 PCLE procedure performed in our department were retrospectively analyzed. Results Among 34 cases of bile leakage from exploratory incision on the biliary duct, 29 cases were spontaneously healed through an abdominal drainage duct routinely indwelled in the abdominal cavity,... |
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| Keywords: | laparoscope gallstone common bile duct exploration bile leakage |
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