胆囊管残留综合征的临床诊治

摘要

Objective:To summarize the cause, diagnosis and laparoscopic operation experience of cholecystic duct remnant syndrome ( CDRS) . Methods:A retrospective study was performed on the clinical data of 29 patients with CDRS after laparoscopic cholecystectomy (LC) from Jan. 2008 to Jan. 2016. Results:The 29 patients were diagnosed with CDRS by MRCP and cured by laparo-scopic surgery. Conclusions:MRCP is the preferred examination in diagnosis of CDRS,and laparoscopic surgery is the preferable meth-od. Establishing artificial pneumoperitoneum by laparotomy can avoid intra-abdominal organ injury. Exactitude anatomy to abdominal ad-hesions and gallbladder triangle can prevent remnant cholecystic duct.%目的:总结胆囊管残留综合征的发生原因、诊断依据及腹腔镜手术技巧.方法:回顾分析2008年1月至2016年1月收治的29例腹腔镜胆囊切除术后胆囊管残留综合征患者的临床资料.结果:29例患者术前磁共振胰胆管造影均证实为残留胆囊管,行腹腔镜残留胆囊管切除术后均痊愈.结论:确诊胆囊管残留综合征首选磁共振胰胆管造影,择期手术治疗首选腹腔镜残留胆囊管切除术.术中开放式建立气腹,以免损伤腹腔内脏器.仔细分离腹腔粘连,充分解剖胆囊三角,避免再次发生残留胆囊管.