腹腔镜胆囊切除术并发胆漏的原因及防治

    The causes and prevention of bile leakage caused by laparoscopic cholecystectomy

    • 摘要: 目的:探讨腹腔镜胆囊切除术并发胆漏的原因和防治方法。方法:对8例腹腔镜胆囊切除术并发胆漏患者的临床资料进行分析。结果:术后早期胆漏6例,系胆囊床毛细胆管或迷走胆管损伤所致,经腹腔引流和药物治疗治愈;迟发性胆漏2例,1例漏口位于肝总管,1例位于右肝管,2例经漏口修补+T管胆道引流治愈,随访6个月至2年无胆管炎发作且无胆管狭窄。结论:肝外胆管、迷走胆管损伤是腹腔镜胆囊切除术后胆漏的主要原因,建立通畅的腹腔引流,修补损伤胆管、T管支撑引流是治疗腹腔镜胆囊切除术后胆漏、预防并发症出现的主要方法。

       

      Abstract: Objective:To investigate the causes and treatment of bile leakage caused by laparoscopic cholecystectomy(LC).Methods:The clinical data of 8 cases with bile leakage caused by LC were retrospectively analyzed.Results:Six cases with bile leakage caused by aberrant bile duct or cholangiole injuries were cured with abdominal cavity drainage and drugs.Two cases with late-occurred bile leakage including 1 case opening in common hepatic duct and 1 case opening in right hepatic duct were cured by opening repair and T-tube drainage.No cholangitis and bile duct stenosis were found during following-up for 6 months to 2 years.Conclusions:Extrahepatic bile duct and aberrant bile duct injuries were the most common reasons of bile leakage after LC.Abdominal cavity drainage,bile duct repair and T-tube drainage are the main methods to treat bile leakage after LC and prevent complications.

       

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