Huang S M, Wu C W, Hong H T, King K L, Lui W Y
Department of Surgery, Veterans General Hospital, National Yang-Ming Medical College, Taipei, Taiwan, Republic of China.
Br J Surg. 1993 Dec;80(12):1590-2. doi: 10.1002/bjs.1800801232.
Between January 1991 and July 1992, 350 laparoscopic cholecystectomies were performed. There were six biliary complications (1.7 per cent): common bile duct (CBD) injury (one patient), delayed CBD necrosis (one), immediate postoperative bile leakage (one) and delayed bile leakage (three). All six patients required laparotomy. Primary repair with long-arm T tube splinting for 3 months was performed for the CBD injury. Religation of the cystic duct was carried out after immediate postoperative bile leakage. Laparotomy with T tube choledochostomy only was performed in the three patients with delayed bile leakage, and hepatojejunostomy Roux-en-Y was undertaken for CBD necrosis. The patient with primary repair of the CBD injury required choledochojejunostomy Roux-en-Y 18 months later for stenosis. Episodes of intermittent cholangitis occurred in the patient with CBD necrosis. The outcome for the four patients with bile leakage was good. There were no deaths.
1991年1月至1992年7月期间，共进行了350例腹腔镜胆囊切除术。出现了6例胆道并发症（1.7%）：胆总管（CBD）损伤（1例患者）、延迟性CBD坏死（1例）、术后即刻胆漏（1例）和延迟性胆漏（3例）。所有6例患者均需剖腹手术。对CBD损伤患者进行了长臂T管支撑3个月的一期修复。术后即刻胆漏患者进行了胆囊管重新结扎。3例延迟性胆漏患者仅进行了剖腹T管胆总管造口术，CBD坏死患者进行了肝空肠吻合Roux-en-Y术。CBD损伤一期修复的患者18个月后因狭窄需要进行Roux-en-Y胆总管空肠吻合术。CBD坏死患者发生了间歇性胆管炎。4例胆漏患者的预后良好。无死亡病例。
