摘要
目的:探讨腹腔镜胆囊切除术中胆囊床肝中静脉属支损伤出血的处理方法及可行性评价。方法:回顾分析2015年3月至2018年1月共1 356例腹腔镜胆囊切除患者的临床资料,其中8例术中发生胆囊床肝中静脉属支损伤出血。结果:8例患者均先行纱布压迫止血,其中1例中转开腹缝扎损伤血管,7例在腹腔镜下用Hem-o-lok夹闭损伤的血管,术后无严重并发症发生,复查肝功能均无明显异常,8例患者均痊愈出院。术后随访6～12个月,均无并发症发生。结论:腹腔镜下处理胆囊床肝中静脉属支损伤出血安全、有效,冷静操作及保持良好的术野是有效控制出血的前提,纱布压迫受损创面是控制出血的首选,但腹腔镜下处理困难时应及时中转开腹。
Objective ： To explore the treatment and its feasibility of the middle hepatic vein branch injury and bleeding in gall-bladder bed during laparoscopic cholecystectomy. Methods：The clinical data of 1 356 patients who underwent laparoscopic cholecystec-tomy between Mar. 2015 and Jan. 2018 were retrospectively analyzed. Among them,8 patients suffered from injury and hemon＇hage of the middle hepatic vein branch. Results ： Gauze compression hemostasis was firstly performed for the 8 patients. 1 case was c.onverted to lap-arotomy for suture of the injury middle hepatic vein branch,7 patients underwent laparoscopic Hem-o-lok close of damaged blood ves-sels. No serious complications occurred after operation, there was no obvious abnormality in the review of liver function. All the 8 pa-tients were cured and discharged,and no complications occurred during the follow-up of 6-12 months. Conclusions：Laparoscopic treat-ment for injury and hemorrhage of the middle hepatic vein branch in gallbladder bed is safe and effective, calm operation and maintai-ning a clear vision is the premise of effective control of bleeding, and gauze compression impaired wound is the first choice to stop bleeding during laparoscopic eholecystectomy. But when the laparoscopic treatment for bleeding is difficult, it slould he timely converted to open surgery.
作者
黎朝良
丁佑铭
黄鹏
童庆华
LI Chao-liang;DING You-ruing;HUANG Pengl(Department of General Surgery,the First People＇s Hospital of Jiangxia District（Union Jiangnan Hospital of Huazhong University of Science and Technology）,Wuhan 430200,China;Renmin Hospital of Wuhan U-niversity)
出处
《腹腔镜外科杂志》
2018年第6期448-450,共3页
Journal of Laparoscopic Surgery
关键词
胆囊切除术
腹腔镜
肝中静脉
出血
Cholecystectomy
laparoscopic
Middle hepatic vein
Hemorrhage
