摘要
目的：探讨腹腔镜胆囊切除术胆道损伤发生的原因、预防及处理。方法：回顾性分析笔者所在医院2008年9月～2012年3月年开展的2143例腹腔镜胆囊切除术中13例胆道损伤的患者的临床资料，分析胆道损伤的原因、处理方法并总结。结果：发生胆道损伤13例，发生率为0.60%，胆囊床小胆管损伤3例，胆囊管残端胆漏2例，副肝管损伤2例，单纯主胆管损伤5例，其中胆总管横断伤2例，肝总管大部分缺损2例，肝总管侧壁电灼穿孔1例，经胆管壁修补、胆管对端吻合或胆肠吻合术后11例痊愈，治愈率84.61%。结论：胆道损伤是腹腔镜胆囊切除术中常见并发症，原因是多方面的，术中操作要仔细，一旦发生损伤需采取适合的修复方法及时处理，保证患者安全。
Abstract
objective:To investigate the cause of biliary duct injury in laparoscopic cholecystectomy, and to find out the ways to its treatment and prevention.Methods:13 cases of the biliary duct injury out of 2143 cases in laparoscopic cholecystectomy colected from Sep.2008 to Mar.2012 were analyzed retrospectively,the reasons and the treatment of biliary duct injury were analyzed and summarized.Results:there existed 13 cases of biliary duct injury,the incidence was 0.60%,3 cases were smal bile ducts in the galbladder bed,2 cases were cystic duct bile leadage,2 cases were accessory hepatic duct injury,5 cases were biliary duct injury alone,2 of them were common bile duct transverse injury,2 of them were majority defect of ductuli hepaticus communis,and the rest 1 case was fulgurate perforation in the side wal of common hepatic duct.11 cases recovered via bile duct operation,bile duct end to end anastomosis and bile enteric anastomosis.,the corresponding cure rate reached 84.61%.Conclusion:bile duct was the common complication in the Laparoscopic Cholecystectomy,its reason was various, careful operation is necessary for the LC,and the comfortable repair method must be employed in time to ensure the patients’ safety when the injury occurred.
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