腹腔镜胆囊切除术致医源性胆道损伤再手术效果的相关因素分析

摘要

[目的]探讨腹腔镜胆囊切除术( laparoscopic cholecystectomy，LC)致医源性胆道损伤（iatrogenic bile duct injury，IBDI）的再次手术效果的相关因素。[方法]分析2000年1月至2012年1月间本院收治的20例LC致IBDI的临床资料,分别从LC致IBDI的临床特点、手术时机、手术技术等方面探讨再手术中的相关因素。[结果]LC致IBDI再次手术的效果受手术时机、既往术中处理方式、术者操作水平影响。[结论]LC致IBDI的修复时机及处理方式是影响患者预后的决定性因素，最好术中及时发现、修复，修复手术应由经验丰富的胆道外科医师实施。%[Objective] To discuss the relative factors of re-operational effect on iatrogenic bile duct injury(IBDI)induced by laparoscopic cholecystecto-my(LC). [Method] Make analysis on the clinical data of 20 cases of LC-induced IBDI, respectively discussing the relative factors of clinical features, opera-tional opportunity and technology in the operation of IBDI. [Result] LC-induced IBDI was influenced by operational opportunity, the treatment in the past operation and operator’s level of operation for the effect. [Conclusion] The repair opportunity and treatment of LC-induced IBDI were the decisive factors influencing patients’prognosis;it’s better to find and repair timely and for the surgeon with rich experience to do the operation.