腹腔镜胆囊切除术胆管损伤21例临床分析

摘要

目的 探讨腹腔镜胆囊切除术中胆管损伤的常见原因及其防治措施.方法 回顾性分析2586例实施腹腔镜胆囊切除术中出现胆管损伤21例病人的临床资料.结果 胆管损伤主要原因为术者操作技术、胆囊管或胆道变异、胆囊颈结石嵌顿、Calot三角区解剖结构不清、肝门部组织粘连等.结论 严格腹腔镜技术训练、掌握解剖变异、提高胆道外科技术素质、忌术中操作粗暴可有效防止胆管损伤.%Objective To discuss the causes, preventions and managements of biliary duct injury caused by laparoscopic cholecystectomy (LC). Methods The clinical data of 21 patients with biliary duct injury caused by LC (in all 2586 cases) were retrospectively analyzed. Results There were various causes of biliary duct injury by LC, including operating skills of surgeons, biliary duct heteromor-phosis, stone incarceration in neck of gallbladder, unclear anatomy of Calot triangle, and adhesions in the region of the porta hepatic, etc. Conclusion The biliary duct injury could be avoided effectively by strict training of the laparoscopic skills, having an intimate knowledge of biliary duct heteromorphosis, improving the biliary surgical experience and prohibiting rough operation.