摘要
作者自１９９２年６月～１９９４年５月治疗腹腔镜胆囊切除术（ＬＣ）并发的胆管损伤及高位胆管狭窄１２例，均经手术治愈。根据其损伤原因及特征分为以下六种类型：（１）ＬＣ术中因电凝切割钩引起肝总管或胆总管穿孔（３例）；（２）ＬＣ术中胆囊管残瑞钛夹导电致胆囊肝总管坏死穿孔（１例）；（３）钛夹止血时钳夹肝总管致高位狭窄（１例）；（４）胆总管损伤后行胆管吻合继发肝总管高位狭窄（２例）；（５）ＬＣ中胆总管横断后，行肝总管空肠吻合术后吻合口狭窄（３例），再次手术切开左右肝管，行肝胆管空肠再吻合；（６）ＬＣ术后延迟性高位胆管狭窄（２例）。作者对胆管损伤的预防措施及治疗方法进行了讨论，并强调ＬＣ胆管损伤严重性和进一步提高认识并积累经验的必要性。
AbstractTwelve patients with iatrogenic bile duct injuriesoccurred during laparoscopic cholecystectomy(LC)were treated from June 1992 to May 1994.All the pa-tients underwent re-operation and were cured. Thecauses and characteristics of the inlurieswere:(1)per-foration of the common hepatic or common bile ductcaused by dissecting hook(3 cases );( 2 ) necrosis andperforation of the common hepatic duct due to diather-mic injury(1 case);(3)clamping of the common hep-atic duct by Ti clip(1 case);(4)secondary high bileduct stricture following a failed end-to-end anastornosisor hepatico-cholangio-jejunostcmy of the amputatedcommon hepatic duct(5 cases );(5)delayed high bileduct stricture( 2 cases ).It is emphasized that theseveritv of bile duct inluries bv LC be should not over-looked,and more experience in this field be accumulat-ed to avoid this serious complication.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1995年第11期647-649,共3页
Chinese Journal of Surgery
