Chen X, Mao J, Wang S, Ru S, Qin X, Luo D, Li S, Duan Z, Wei S, Zhou C
Department of General Surgery, Kunming General Hospital, China.
Ann Acad Med Singap. 1995 Mar;24(2):312-5.
Over a 2-year period, from 12 September 1991 to 11 September 1993, laparoscopic cholecystectomy was performed on 1475 patients with benign gallbladder disease in Kunming General Hospital, Yunnan, China. Of these, 28 cases (1.9%) were converted to open surgery. Various complications were documented in 27 instances including extrahepatic bile duct injury in 4 cases (0.3%), postoperative haemorrhage requiring laparotomy in 3 cases (0.2%) and bile leak from cystic duct stump in 1 case (0.07%). There was 1 (0.07%) death in the series. The junction between the gallbladder infundibulum and the cystic duct is an important landmark which laparoscopic surgeons must identify in the course of the procedure. Because the junction remains a comparatively constant landmark, in difficult laparoscopic cholecystectomy, excessive dissection of the bile duct would be unnecessary. During dissection of the hepatic hilus, blund dissection is recommended and the blind use of cautery and haemostasis should be avoided.
在1991年9月12日至1993年9月11日的两年期间，中国云南昆明总医院对1475例患有良性胆囊疾病的患者实施了腹腔镜胆囊切除术。其中，28例（1.9%）转为开腹手术。记录到27例出现各种并发症，包括4例肝外胆管损伤（0.3%）、3例需要剖腹手术的术后出血（0.2%）和1例胆囊管残端胆漏（0.07%）。该系列中有1例（0.07%）死亡。胆囊漏斗与胆囊管的交界处是一个重要的标志，腹腔镜外科医生在手术过程中必须识别。由于该交界处仍然是一个相对恒定的标志，在困难的腹腔镜胆囊切除术中，无需对胆管进行过度解剖。在肝门解剖过程中，建议钝性解剖，应避免盲目使用烧灼和止血。
