腹腔镜胆囊切除术后近期黄疸原因分析及处理

目的:探讨腹腔镜胆囊切除术(LC)后黄疸的原因、预防及处理。方法:回顾分析21例LC术后黄疸的临床资料。结果:本组术后黄疸的原因为胆道残留结石、肝外胆管损伤、胆漏、胆总管下端炎性狭窄及急性肝功能损害。分别采用EST、开腹手术和保守治疗,取得较好疗效。结论:LC术后黄疸原因以胆道残留结石、胆漏最为常见,要注意一些少见原因,如胆总管内钛夹游走、胆道功能障碍和胆红素代谢障碍,ERCP检查是获得确诊的有效手段,及时正确的处理能取得很好的治疗效果。

Causes and treatment of jaundice following laparoscopic cholecystectomy

Objective:To investigate the causes prophylaxis and treatment of jaundice following laparoscopic cholecystectomy.Methods:The records of 21 cases with jaundice following laparoscopic cholecystectomy were retrospectively analyzed.Resulsts:Causes of postoperative jaundice in this group include:residual choledocholithiasis,injury of extrahepatic bile duct,bile leakage,inflamed stricture in the inferior part of the commen bile duct and acute liver function infraction.EST,laparotomy and conservative treatment were executed respectively and had obtained satisfied results.Conclusions:Residual choledocholithiasis and bile leakage were the leading causes of jaundice following laparoscopic cholecystectomy,while rare causes of postoperative jaundice,for example migration of titanium clips,functional disturbance of biliary tract and dysbolism of bilirubin need being paid close attention to.ERCP is a useful means to get the final diagnosis and prompt etiologic therapy may effectively relieve the symptoms.