Walsh R M, Chung R S, Grundfest-Broniatowski S
Department of General Surgery, Cleveland Clinic Foundation, OH 44195, USA.
Surg Endosc. 1995 Jan;9(1):67-70. doi: 10.1007/BF00187890.
Dissection and transection of the cystic duct close to the gallbladder has been advocated as a means of avoiding common bile injury during laparoscopic cholecystectomy (LC). We present three cases in which inadequate identification of the gallbladder-cystic duct junction resulted in incomplete cholecystectomy. In two patients an unsecured gallbladder infundibulum presented as cystic duct leaks and one patient developed recurrent symptomatic cholelithiasis. These cases emphasize the need for complete dissection and visualization of the cystic duct at the gallbladder prior its division and secure ligation during LC.
在腹腔镜胆囊切除术(LC)中,提倡在靠近胆囊处解剖和横断胆囊管,以此作为避免胆总管损伤的一种方法。我们报告3例因胆囊-胆囊管交界处识别不清而导致胆囊切除不完全的病例。2例患者出现胆囊漏斗部固定不牢,表现为胆囊管漏,1例患者出现复发性症状性胆石症。这些病例强调,在LC过程中,在切断胆囊管之前,需要对胆囊处的胆囊管进行完整的解剖和可视化,并进行可靠的结扎。