摘要
目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后迟发性胆漏的发生原因及处理措施。方法:回顾分析LC术后10例迟发性胆漏患者的临床资料。结果:迷走胆管漏6例,均行腹腔镜探查术,于胆囊床迷走胆管上WECK夹,并缝扎,经通畅引流治愈。2例胆总管侧壁漏行胆总管修补加"T"管引流治愈。2例胆囊管撕裂致残端漏经腹腔镜探查腹腔引流,行内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)和内镜鼻胆管引流(endoscopic naso-biliary drainage,ENBD)治愈。结论:LC术后迟发性胆漏有特定的发生原因,是可以减少或避免的。建立通畅的腹腔引流和胆管引流或行腹腔镜探查结合ERCP+ENBD是治疗LC术后迟发性胆漏的可行方法。
Objective：To discuss causes and treatment measures of delayed bile leakage after laparoscopic cholecystectomy （LC）. Methods ：The clinical data of 10 patients suffering from delayed bile leakage after LC was collected and retrospectively anayzed. Results：Six cases of aberrant bile duct leakage underwent laparoscopic exploration. WECK clips and suture were applied to the aberrant bile duct. The patients were cured after peritoneal drainage. 2 cases of lateral wall leakage of common bile duct were cured by repair of common bile duct and T-tube drainage. ：2 cases of cystic duct laceration and cystic duct stump leakage were cured after laparo- scopic exploration, peritoneal drainage, endoscopic retrograde cholangiopancreatography （ERCP） and endoscopic nasobiliary drainage （ENBD）. Conclusions： Delayed bile leakage after LC has specific reasons and can be decreased or avoided. Establishment of unobstructed abdominal drainage and biliary drainage, laparoscopic exploration combined with ERCP and ENBD are feasible treatments for delayed bile leakage after LC.
出处
《腹腔镜外科杂志》
2010年第3期215-217,共3页
Journal of Laparoscopic Surgery
关键词
胆囊切除术
腹腔镜
迟发性胆漏
手术后并发症
Cholecystectomy, laparoscopic
Delayed bile leakage
Postoperative complications
