腹腔镜胆囊切除术胆管损伤的预防对策（附600例分析）

摘要

目的总结连续开展腹腔镜胆囊切除术（LC）600例无胆管损伤等严重并发症的成功经验。方法回顾分析本组成功实施LC 600例的临床资料，其中胆囊结石466例，急性胆囊炎23例，胆囊息肉85例，胆囊结石合并息肉15例，慢性胆囊炎11例。结果完成588例，中转手术12例，600例全部治愈，无胆管损伤等严重并发症发生。结论严格的技术培训，采用钝性锐性分离相结合法谨慎解剖Calot三角，适时中转手术是成功避免LC术中胆管损伤等严重并发症的关键。%Objective　To summarize the successful experience of LC 600 cases without biliary tract injury and other severe complications.Methods　Retrospective analysis was made on 600 patients underwent LC successfully including 466 cases of gallbladder gallstone, 23 cases of acute cholecystitis, 85 cases of gallbladder polyps, 15 cases of gallbladder gallstone with polyps, 11 cases of chronic cholecystitis.Results　LC was performed on 588 cases, 12 cases converted to open cholecystectomy. All patients were cured without biliary tract injury and other severe complications.Conclusion　It is key point for preventing biliary tract injury to keep strict technique training,to disect carefully the calot triangle by dull and sharp dissection, and to convert to open cholecystectomy timely.