摘要
目的探讨腹腔镜胆囊切除术中胆囊颈管结石漏诊的原因及其预防。方法回顾性分析我院自1999年1月～2005年1月收治的腹腔镜胆囊切除术后胆囊颈管残留结石10例的临床资料。结果本组病例术前均经B型超声、MRCP、ERCP确诊,均经再次手术治愈。结论手术中忽视或判断失误;急性炎症胆囊三角解剖不清;遗留过长的胆囊管及胆囊管畸形、变异是腹腔镜胆囊切除术中胆囊管结石漏诊的主要原因。术中胆道造影、术前B型超声筛查、术中B型超声引导是及时发现胆囊颈管结石残留的主要方法。
Objective To explore the reasons and prevention of cystic duct remnant calculi in laparoscopic cholecystectomy. Methods The clinical data of 10 cases of cystic duct remnant calculi after laparoscopic cholecystectomy from January 1999 to January 2005 were analyzed retrospectively. Resuits All the 10 patients were cured by re-operation after accurate preoperative diagnosis by B ultrasound,MRCP,ERCP. Conclusion The main causes for cystic duct remnant calculi after laparoscopic cholecystectomy were as follows.Incorrect identification during operation; unclear anatomy of calot triangle; the rest of cystic duct was too long. This entity can be prevented by routine use of preoperative B ultrasound, intraoperative cholangiography, intraoperative ultrasongraphy.
出处
《腹部外科》
2007年第6期340-341,共2页
Journal of Abdominal Surgery
关键词
胆囊切除术
腹腔镜
胆囊管
结石
Cholecystectomy, laparoscopic
Cystic duct
Calculi
