CAJ | 학술논문

目的:总结腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)胆管损伤处理经验.方法:回顾性分析30例LC胆管损伤患者的临床资料,并根据胆管损伤的部位、程度及发现的时间采取不同的手术方式.结果:9例于术中及时发现并处理治愈,术后发现21例胆管损伤,病死2例,1例死于胆漏、腹腔感染,另1例死于反复胆管炎、肝功能不全;其余均治愈.结论:LC手术过程应严格遵守操作规程,避免盲目或轻率的钳夹、电切、电凝是预防胆管损伤的关键,发现胆管损伤需行一期或二期手术治疗,降低病死率.
목적:총결복강경담낭절제술(laparoscopic cholecystectomy,LC)담관손상처리경험.방법:회고성분석30례LC담관손상환자적림상자료,병근거담관손상적부위、정도급발현적시간채취불동적수술방식.결과:9례우술중급시발현병처리치유,술후발현21례담관손상,병사2례,1례사우담루、복강감염,령1례사우반복담관염、간공능불전;기여균치유.결론:LC수술과정응엄격준수조작규정,피면맹목혹경솔적겸협、전절、전응시예방담관손상적관건,발현담관손상수행일기혹이기수술치료,강저병사솔.
Objective:To summarize the experience in prevention and treatment of bile duct injury during laparoscopic cholecysteclomy (LC).Methods:Retrospective analysis on the clinical data of 30 cases of LC was carried out.The different operation modes were selected according to the injury area and degree of bile duct and the discovered time.Results:Nine cases who treated urgently were recovered well during the operation period.In the 21 cases who were found with bile duct injury after the operation,two cases were died,and in which one was died with leakage of bile and celiac infection,and another was died with reiterative cholangitis and hepatic insufficiency.Other cases were recovered well.Conclusions:During LC,the operative rule should always be strictly complied and the key to preventing bile duct injury is to avoid clipping,cutting and coagulationblindly blindly.