CAJ | 학술논문

腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中手术区域的出血是困扰外科医生的一个重要问题.除了胆囊动脉破裂之外,由胆囊床引发的出血也是LC术中常见的出血原因之一,而其中位于胆囊床后方肝中静脉属支的破裂所导致的胆囊床出血则更是术中非常棘手的问题,这不仅会使原本简单的手术复杂化,模糊手术区域的解剖结构,还往往可导致严重的手术并发症,是构成Lc术中转开腹的主要因素之一.本文就肝中静脉属支的局部解剖、损伤后的处理及损伤的预防进行综述.
복강경담낭절제술(laparoscopic cholecystectomy,LC)중수술구역적출혈시곤우외과의생적일개중요문제.제료담낭동맥파렬지외,유담낭상인발적출혈야시LC술중상견적출혈원인지일,이기중위우담낭상후방간중정맥속지적파렬소도치적담낭상출혈칙경시술중비상극수적문제,저불부회사원본간단적수술복잡화,모호수술구역적해부결구,환왕왕가도치엄중적수술병발증,시구성Lc술중전개복적주요인소지일.본문취간중정맥속지적국부해부、손상후적처리급손상적예방진행종술.
The hemorrhage during laparoscopic cholecystectomy (LC) in operating field is a significant puzzle worries the surgeon. Besides disrupting the cystic artery hemorrhage originating from the gallbladder bed also plays a frequent role in the cause of bleeding in LC. The gallbladder bed bleeding which results from the disrupt of the branches of the middle hepatic vein is a ticklish problem in the operation. It will complicate the surgical operation, confuse the anatomic structttre, cause serious complications and is a main reason for conversion. Thus, we compose this review to expound the topographic anatomy of the branches of the middle hepatic vein as well as the prevention and treatment to the injure of the branches of the middle hepatic vein.