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[腹腔镜胆囊切除术过程中的医源性胆管损伤]

[Iatrogenic bile duct injuries during the process of laparoscopic cholecystectomy].

作者信息

Qian G, Wu M, Zhang Y

机构信息

Institute of Hepatobiliary Surgery of Changhai Hospital, Second Military Medical University, Shanghai.

出版信息

Zhonghua Wai Ke Za Zhi. 1995 Nov;33(11):647-9.

PMID:8731906
Abstract

Twelve patients with iatrogenic bile duct injuries occurred during laparoscopic cholecystectomy (LC) were treated from June 1992 to May 1994. All the patients underwent re-operation and were cured. The causes and characteristics of the injuries were: (1) perforation of the common hepatic or common bile duct caused by dissecting hook (3 cases); (2) necrosis and perforation of the common hepatic duct due to diathermic injury (1 case); (3) clamping of the common hepatic duct by Ti clip (1 case); (4) secondary high bile duct stricture following a failed end-to-end anastomosis or hepatico-cholangio-jejunostomy of the amputated common hepatic duct (5 cases); (5) delayed high bile duct stricture (2 cases). It is emphasized that the severity of bile duct injuries by LC be should not overlooked, and more experience in this field be accumulated to avoid this serious complication.

摘要

1992年6月至1994年5月,对12例腹腔镜胆囊切除术(LC)中发生医源性胆管损伤的患者进行了治疗。所有患者均接受了再次手术并治愈。损伤的原因及特点为:(1)解剖钩致肝总管或胆总管穿孔(3例);(2)电灼损伤致肝总管坏死穿孔(1例);(3)钛夹夹闭肝总管(1例);(4)离断的肝总管端端吻合或肝管空肠吻合失败后继发高位胆管狭窄(5例);(5)迟发性高位胆管狭窄(2例)。强调不应忽视LC所致胆管损伤的严重性,应积累更多该领域经验以避免这一严重并发症。

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