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腹腔镜胆囊切除术后Luschka管胆汁漏的腹腔镜治疗

[Laparoscopic treatment of bile leakage from the Luschka duct after laparoscopic cholecystectomy].

作者信息

Bátorfi József, Baranyay Ferenc, Simon Eva, Beznicza Henrietta, Kolonics Gyula

机构信息

Nagykanizsa Megyei Jogú Város Kórháza, Altalános Sebészeti Osztály.

出版信息

Orv Hetil. 2004 May 16;145(20):1061-4.

Abstract

The possible reasons for bile leakage following laparoscopic cholecystectomy are the injury of the common bile duct, the insufficient treatment of cystic duct (non competent or non closing, or spontaneously removing clip, stumpnecrosis due to electrocoagulation near to clipp, rupture adjacent to the clipp) or the opening of an aberrant bile duct. The latter often may occur in case of the anatomic variation described by Hubert von Luschka (1820-1875) a German anatomist as the duct named after Luschka. In a favorable case the accessory bile duct closes by itself, but occasionally developing biloma and/or biliary peritonitis need to be operated on. The authors write about the case of a 52 years old female patient, who underwent laparoscopic cholecystectomy, and 3 days later the complication was averted through the application of relaparoscopy with intracorporal suture. In connection with this case the authors acquaint the readers with the biography, the academic carrier of Hubert von Luschka, and the literature related to Luschka duct is surveyed.

摘要

腹腔镜胆囊切除术后胆漏的可能原因包括胆总管损伤、胆囊管处理不当(无功能或未闭合、夹子自行脱落、靠近夹子处电凝导致残端坏死、夹子附近破裂)或异常胆管开口。后者常发生于德国解剖学家胡贝特·冯·卢施卡(1820 - 1875)所描述的解剖变异情况下,即以此人命名的卢施卡管。在有利情况下,副胆管可自行闭合,但偶尔会形成胆汁瘤和/或胆汁性腹膜炎,需要进行手术治疗。作者报道了一例52岁女性患者的病例,该患者接受了腹腔镜胆囊切除术,术后3天通过再次腹腔镜手术及体内缝合避免了并发症。结合该病例,作者向读者介绍了胡贝特·冯·卢施卡的生平、学术生涯,并对与卢施卡管相关的文献进行了综述。

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