Department of Surgery (112), University of California San Francisco and San Francisco VA Medical Center, San Francisco, CA 94121, USA.
Surg Clin North Am. 2014 Apr;94(2):297-310. doi: 10.1016/j.suc.2014.01.008.
Because it offers several advantages over open cholecystectomy, laparoscopic cholecystectomy has largely replaced open cholecystectomy for the management of symptomatic gallstone disease. The only potential disadvantage is a higher incidence of major bile duct injury. Although prevention of these biliary injuries is ideal, when they do occur, early identification and appropriate treatment are critical to improving the outcomes of patients suffering a major bile duct injury. This report delineates the key factors in classification (and its relationship to mechanism and management), identification (intraoperative and postoperative), and management principles of these bile duct injuries.
由于腹腔镜胆囊切除术相对于开放性胆囊切除术具有诸多优势，因此腹腔镜胆囊切除术在治疗有症状的胆囊结石病方面已基本取代了开放性胆囊切除术。唯一潜在的缺点是胆管损伤的发生率较高。尽管预防这些胆道损伤是理想的，但当它们确实发生时，早期识别和适当的治疗对于改善遭受严重胆管损伤的患者的结局至关重要。本报告阐述了这些胆管损伤的分类（及其与机制和处理的关系）、识别（术中及术后）和处理原则的关键因素。
