腹腔镜胆囊切除术后胆漏的诊治体会(附34例报告)

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后胆漏的原因及诊治措施。方法:回顾分析2000年2月至2012年2月LC术后34例患者发生胆漏的临床资料。结果:开腹手术治疗3例,B超引导下穿刺引流6例(引流管引流不畅所致),保守治疗25例。患者治疗后均痊愈,无胆管狭窄、胆管炎、再次胆漏及腹腔脓肿等严重并发症发生。结论:术前严格掌握手术适应证,术中精细解剖胆囊三角,以减少术后胆漏的发生;术中胆囊三角解剖不清时,放置引流是必须的。

Diagnosis and treatment of biliary leakage after laparoscopic cholecystectomy with a report of 34 cases

Objective：To investigate the cause and treatment of biliary leakage after laparoscopic cholecystectomy.Methods： The clinical data of 34 patients who suffered from biliary leakage after LC between Feb.2000 and Feb.2012 were analyzed retrospectively.Results：Open surgery were conducted in 3 patients,B ultrasound-guided percutaneous cholecystostomy were executed in 6 patients,25 patients received conservative treatment.All patients were cured with no stenosis of bile duct,cholangitis,recurrence,or peritoneal abscess occurred.Conclusions：A strict control of operation indication as well as meticulous management of Calot＇s triangle can help to reduce incidence of postoperative biliary leakage.It is necessary to place abdominal drainage when Calot＇s triangle can not be fully dissected.