Erhard J, Krause U, Hellinger A, Krischer V, Eigler F W
Department of General Surgery, University Clinic, Essen, Germany.
Langenbecks Arch Chir. 1995;380(6):304-7. doi: 10.1007/BF00207216.
Laparoscopic cholecystectomy involves a higher incidence of severe common bile duct injury than did open cholecystectomy. The severe injuries most often result from technical problems and inadequate exposure. Reconstruction of the bile duct is then possible provided that an immediate diagnosis is made and an appropriate surgical technique is applied. The report focuses on a new method of reconstruction of the common bile duct by interposition of a small jejunal conduit. The procedure was performed in five patients with severe bile duct injury (Bismuth class 3-4) that occurred during laparoscopic cholecystectomy. The outcome after follow-up periods of 9 months to more than 2 years is promising. This method of reconstruction is therefore recommended for severe forms of bile duct injury.
与开腹胆囊切除术相比，腹腔镜胆囊切除术导致严重胆总管损伤的发生率更高。严重损伤大多源于技术问题和暴露不充分。只要能立即做出诊断并应用合适的手术技术，胆管重建就是可行的。本报告重点介绍一种通过置入一小段空肠导管来重建胆总管的新方法。该手术应用于5例在腹腔镜胆囊切除术期间发生严重胆管损伤（Bismuth 3 - 4级）的患者。在9个月至2年多的随访期后的结果很有前景。因此，对于严重形式的胆管损伤，推荐这种重建方法。
