Neuhaus P, Schmidt S C, Hintze R E, Adler A, Veltzke W, Raakow R, Langrehr J M, Bechstein W O
Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Humboldt Universität zu Berlin.
Chirurg. 2000 Feb;71(2):166-73. doi: 10.1007/s001040051033.
Iatrogenic bile duct lesions are serious complications during laparoscopic cholecystectomy and include biliary leakage and major bile duct injury. The incidence of biliary lesions following laparoscopic cholecystectomy is up to threefold higher than that of the open procedure. A total of 108 patients with bile duct lesions after laparoscopic cholecystectomy were treated at our institution. Endoscopic treatment was successful in 68 cases, 6 patients were treated by external drainage, and 34 patients required surgical therapy. Selection criteria for the type of treatment included the etiology, anatomical situation, and diagnostic interval of the biliary lesion. We suggest a classification of bile duct injury and a proposal for diagnosis and treatment of these complications.
医源性胆管损伤是腹腔镜胆囊切除术期间的严重并发症，包括胆漏和主要胆管损伤。腹腔镜胆囊切除术后胆管损伤的发生率比开腹手术高出两倍。我院共治疗了108例腹腔镜胆囊切除术后胆管损伤患者。68例内镜治疗成功，6例采用外引流治疗，34例需要手术治疗。治疗方式的选择标准包括胆管损伤的病因、解剖情况和诊断间隔时间。我们提出了胆管损伤的分类以及这些并发症的诊断和治疗建议。
