国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2011年
12期
1432-1434
,共3页
梁志宇%杨富芝%伍发时%欧荣星%冯春成
樑誌宇%楊富芝%伍髮時%歐榮星%馮春成
량지우%양부지%오발시%구영성%풍춘성
囊管疾病%胆囊切除术%小切口%胆道损伤
囊管疾病%膽囊切除術%小切口%膽道損傷
낭관질병%담낭절제술%소절구%담도손상
Gallbladder disease%Cholecystectomy%Minor-incision%Bile duct injuries
目的 探讨小切口胆囊切除术致胆道损伤的原因及其预防措施和处理方法.方法 选择948例行小切口胆囊切除术患者,发生胆道损伤5例,回顾性分析其临床资料.结果 5例施行修补手术的患者,T管支撑时间为0.5~1a,拔管前胆道造影没有狭窄现象,拔管后无胆漏及梗阻性黄疸.5例患者均获得随访,随访时间为2~10 a,无死亡,术后效果良好.结论 小切口胆囊切除术虽具有切口小、恢复快、术后瘢痕小、费用低等优点,但是如果处理不当也会造成严蕈的胆道损伤.只要术者严格把握好手术适应征,仔细、规范操作,就可以减少胆道损伤;术后及时发现并妥善处理是减轻患者痛苦的关键.
目的 探討小切口膽囊切除術緻膽道損傷的原因及其預防措施和處理方法.方法 選擇948例行小切口膽囊切除術患者,髮生膽道損傷5例,迴顧性分析其臨床資料.結果 5例施行脩補手術的患者,T管支撐時間為0.5~1a,拔管前膽道造影沒有狹窄現象,拔管後無膽漏及梗阻性黃疸.5例患者均穫得隨訪,隨訪時間為2~10 a,無死亡,術後效果良好.結論 小切口膽囊切除術雖具有切口小、恢複快、術後瘢痕小、費用低等優點,但是如果處理不噹也會造成嚴蕈的膽道損傷.隻要術者嚴格把握好手術適應徵,仔細、規範操作,就可以減少膽道損傷;術後及時髮現併妥善處理是減輕患者痛苦的關鍵.
목적 탐토소절구담낭절제술치담도손상적원인급기예방조시화처리방법.방법 선택948례행소절구담낭절제술환자,발생담도손상5례,회고성분석기림상자료.결과 5례시행수보수술적환자,T관지탱시간위0.5~1a,발관전담도조영몰유협착현상,발관후무담루급경조성황달.5례환자균획득수방,수방시간위2~10 a,무사망,술후효과량호.결론 소절구담낭절제술수구유절구소、회복쾌、술후반흔소、비용저등우점,단시여과처리불당야회조성엄심적담도손상.지요술자엄격파악호수술괄응정,자세、규범조작,취가이감소담도손상;술후급시발현병타선처리시감경환자통고적관건.
Objective To explore the causes, preventive measure and dispose ways in minor-incision cholecystectomy induce bile duct injuries. Methods 948 patients who performed minorincision cholecystectomy were choosed, and 5 cases were caused bile duct injuries by minor-incision cholecystectomy, to retrospectively analyzed their clinical data. Results 5 patients with bile duct injuries, 1 case was small choledochus by congenital, 1 case was anomalies of biliary system, 2 cases were Mirizz syndrome, 1 case was chronic cholecystitis with gall stone, no case had gone against the operative procedure. 4 cases were timely found in surgical operation, and after discover for 1 cases. All patients with bile duct injuries payed the repair operation, no case need to repair again, no death, had better effects. Conclusion The minor-incision cholecystectomy has advantages of minor-incision, comeback fast, small scar and low cost. But it still can cause bad serious bile duct injuries, if you do it with misconduct. So the surgery doctor should pay more attention to the indication,carefulness and correctness in the operation, so as to reduce bile duct injuries,early discovering after operation and dealing with the suitable way are the key points to get the patients'pain lower and lower.