Timerbulatov M V, Grishina E E, Aitova L R, Aziev M M
Bashkir State Medical University, Ufa, Russia.
Ufa City Clinical Hospital No. 21, Ufa, Russia.
Khirurgiia (Mosk). 2022(12):104-108. doi: 10.17116/hirurgia2022121104.
Laparoscopic cholecystectomy has many advantages over open surgery. Nevertheless, incidence of intraoperative bile duct injury is consistently higher for laparoscopic technique. This review is devoted to modern principles of identifying the anatomical elements in hepatoduodenal ligament and rules for safe tissue dissection in this area. The last ones mainly consist in formation of «critical view of safety» before clipping and transection of tubular structures. The key for «critical view of safety» is mobilization of fatty and fibrous tissues of hepatocystic triangle starting from the lower third of the gallbladder.
与开腹手术相比，腹腔镜胆囊切除术有许多优点。然而，腹腔镜技术导致的术中胆管损伤发生率一直较高。本综述致力于探讨在肝十二指肠韧带中识别解剖结构的现代原则以及该区域安全组织分离的规则。后者主要包括在夹闭和横断管状结构之前形成“安全关键视野”。“安全关键视野”的关键是从胆囊下三分之一处开始游离肝胆囊三角的脂肪和纤维组织。
