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腹腔镜修复胆囊切除术中右肝动脉的术中损伤。

Laparoscopic repair for intraoperative injury of the right hepatic artery during cholecystectomy.

作者信息

Fujioka Shuichi, Fuke Azusa, Funamizu Naotake, Nakayoshi Tomoko, Okamoto Tomoyoshi, Yanaga Katsuhiko

机构信息

Department of Surgery, Jikei Daisan Hospital, Tokyo, Japan.

出版信息

Asian J Endosc Surg. 2015 Feb;8(1):75-7. doi: 10.1111/ases.12151.

Abstract

Right hepatic artery (RHA) injury is a complication that occurs during laparoscopic cholecystectomy, which can sometimes cause hepatic artery pseudoaneurysm or ischemic hepatic necrosis. Therefore, RHA should be managed carefully. Herein, we report a case of intraoperative RHA injury that was successfully repaired during laparoscopic cholecystectomy. Bleeding was controlled prior to the cholecystectomy with vascular clamp forceps that had been inserted through an additional trocar, and repair of the RHA injury was then performed laparoscopically. The postoperative course was uneventful, and patency of the RHA and its sectional arteries were confirmed by CT arteriography. Laparoscopic repair of minor RHA injuries can be managed safely if bleeding is adequately controlled.

摘要

右肝动脉(RHA)损伤是腹腔镜胆囊切除术期间发生的一种并发症,有时可导致肝动脉假性动脉瘤或缺血性肝坏死。因此,应对右肝动脉进行仔细处理。在此,我们报告一例在腹腔镜胆囊切除术期间发生的右肝动脉损伤并成功修复的病例。在胆囊切除术之前,通过额外插入的套管针置入血管钳控制出血,然后在腹腔镜下对右肝动脉损伤进行修复。术后病程顺利,通过CT血管造影证实右肝动脉及其分支动脉通畅。如果出血得到充分控制,腹腔镜修复轻微的右肝动脉损伤可以安全进行。

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