目的：探讨以Rouviere 沟作为胆囊管解剖定位标志，以指导腹腔镜胆囊切除术。方法同一初学腹腔镜胆囊切除术手术者自2012年10月至2014年3月于川北医学院附属三台医院连续实施腹腔镜胆囊切除术750例，术中记录Rouviere 沟的出现率，并采用Rouviere 沟为胆囊管解剖定位标志。结果750例中，705例有 Rouviere 沟。全组未发生手术死亡，胆管损伤1例（0.13％），其术中未见 Rouviere 沟。前300例使用三孔法35例，中转30例（10％）；后450例使用三孔法387例，中转15例（3.3％）。结论 Rouviere 沟是重要的胆囊管解剖定位标志，以Rouviere 沟为胆囊管解剖定位标志可以帮助胆囊三角解剖，对于初学腹腔镜胆囊切除术者预防术中胆管损伤有重要临床意义，值得推广应用。%Objective To explore the role of Rouviere′s sulcus as the anatomical landmark for the cystic duct in laparoscopic cholecystecto-my.Methods The clinical data of 750 patients who underwent laparoscopic cholecystectomy operated by one beginner from October 2012 to March 2014 in the Affiliated Santai Hospital of North Sichuan Medical College were analyzed.The frequency of appearance of Rouviere′s sul-cus was recorded during operation,and the Rouviere′s sulcus was used as the anatomical landmark for the cystic duct in laparoscopic chole-cystectomy.Results Of the 750 patients,705 had Rouviere′s sulcus.There was no mortality during operation.Bile duct injury occurred in one case (0.13%),whose Rouviere′s sulcus was not seen during operation.Among the first 300 cases,the three-hole method was used in 35 cases,and 30 cases (10%)were converted to open surgery.Among the succeeding 450 cases,the three-hole method was used in 387 cases,and 15 cases (3.3%)were converted to open surgery.Conclusion Rouviere′s sulcus is an important anatomical landmark for the cystic duct.Its identification before Calot′s triangle dissection may help in preventing the bile duct injury in laparoscopic cholecystectomy for beginners.It has great clinical significance and should be applied widely.
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