Arnaud J P, Bergamaschi R
Department of Visceral Surgery, University of Angers, France.
Surg Laparosc Endosc. 1993 Dec;3(6):487-8.
Most surgeons performing in laparoscopic cholecystectomy have opted for the use of metal clips to secure the cystic duct before division. Accordingly, we have been using double proximal clipping of the cystic duct for our patients. Certain disadvantages of clips are well known, among them, their ability to slip. We report one case of clip migration into the common bile duct, which led to obstructive jaundice. The clip was recovered after endoscopic sphincterotomy. Slipping of the second metal clip lead to biliary peritonitis necessitating surgical drainage. The case presented raises the question of whether suture ligation of the proximal end of the cystic duct should be preferred to clipping.
大多数进行腹腔镜胆囊切除术的外科医生选择在离断胆囊管前使用金属夹来固定。因此，我们一直对患者采用胆囊管近端双重夹闭的方法。夹子存在一些众所周知的缺点，其中包括它们可能会滑脱。我们报告了一例夹子移位至胆总管导致梗阻性黄疸的病例。在内镜括约肌切开术后夹子被取出。第二个金属夹的滑脱导致胆汁性腹膜炎，需要进行手术引流。该病例提出了一个问题，即胆囊管近端的缝合结扎是否应优先于夹闭。
