腹腔镜胆囊切除术12例胆道损伤分析

目的 探讨腹腔镜胆囊切除术（1aparoscopic cholecysteetomy，LC）中胆道损伤的原因、临床表现、诊断及处理。方法 对2003年6月～2010年5月我科行腹腔镜胆囊切除手术患者术中胆道损伤并发症进行回顾性分析。结果 3例胆囊管残端漏，经开腹结扎胆囊管残端治愈；5例胆总管损伤、2例肝总管损伤，再次手术修补后放置T型管引流，6周后拔管治愈；2例为胆总管横断，行胆总管空肠Roux-en-Y吻合术，“T”管支撑，8周后拔管。术后随访患者均恢复良好。结论 腹腔镜胆囊切除术中胆道损伤应及时术中发现、术后严密监护，发现问题及时处理。

Analysis of Laparoscopic Cholecystectomy in 12 Cases of Biliary Tract Injury

Objective To investigate causes,clinical manifestations,diagnosis and treatment of bile duct injury in laparoscopic cholecystectomy. Methods From 2003 June to 2010 May in our department patients with laparoscopic cholecystectomy intraoperative bile duct injury were retrospectively analyzed. Results There were 3 cases of cystic duct stump leakage,the open of ligating the cystic duct stump cured;5 cases of bile duct injury,2 cases of hepatic duct injury after repair operation,both again placing T tube drainage. 6 weeks after extubation cured;2 cases of common bile duct transection underwent the common bile duct jejunum,Roux-en-Y anastomosis operation, ＂T＂pipe support,and extubation after 8 weeks. Postoperative patients recovered well in follow-up visit. Conclusion laparoscopic chole cystectomy bile duct injury should be timely found during the operation, postoperative close monitoring, and be found and treated timely.