摘要
目的 探讨腹腔镜胆囊切除术 ( L aparoscopic Cholecystectomy,L C)术后胆漏的诊治预防措施。方法 对本院1991年 3月～ 2 0 0 1年 5月 92 6 7例 L C术后发生胆漏 31例 ( 0 .33% )的原因进行回顾和分析。结果 全部治愈 ,18例经过非手术治疗 ,占 5 8% ,13例行再次腹腔镜探查或开腹探查手术 ,占 42 %。结论 严格掌握腹腔镜胆囊切除手术适应证 ,沿胆囊壶腹向下分离 ,仔细辨别 Calot三角解剖结构 ,采取顺行和 (或 )逆行结合、适时把握中转开腹手术的时机是预防胆漏等并发症的关键。
Objective To study the diagnosis and precaution of biliary fistula after Laparoscopic holecystectomy.Methods Review and analyse 36(58%) patients of biliary fistula among 9 267 cases who underwent LC from March,1991 to May,2001.Results 36 patients had healed.Eighteen(58%) cases healed without operation;thirteen(42%) cases underwent laparoscopic agian and laparotomy.Conclusion It must grasp indication of Laparoscopic Cholecystectomy strictly,separate gallbladder ampullae downword,distinguish anatomical structure of calot trigone carefully combine the direct and/or retrogradation method.It is the key step of grasping proper occasion of transfer to laparotomize.It is the key step to prevent complications such as biliary fistula,too.
出处
《肝胆外科杂志》
2001年第6期432-433,共2页
Journal of Hepatobiliary Surgery
关键词
腹腔镜
胆囊切除术
胆漏
并发症
Laparoscopic cholecystectomy
Cholecystectomy
Biliary fistula
Complication
