CAJ | 학술논문

目的：探讨腹腔镜胆囊切除术( LC)中18例胆管损伤( BDI)原因及处理方法。方法我院1996年至2012年共完成6542例腹腔镜胆囊切除术( LC)，其中18例发生胆管损伤，对其原因，损伤的部位进行探讨。结果其中解剖病理因素10例，操作因素8例。损伤部位：胆总管11例，肝总管5例，右肝管2例。14例经中转开腹11例行胆管修补加T管支撑。3例行胆总管空肠吻合术加支撑。 LC术后因出现胆汁性腹膜炎再手术发现胆管损伤4例，其中胆总管损伤3例，肝总管损伤1例。3例行胆管修补加T管支撑。1例行胆管端端吻合术加T管支撑。结论掌握好中转开腹时机是避免LC胆管损伤的重要环节。
목적：탐토복강경담낭절제술( LC)중18례담관손상( BDI)원인급처리방법。방법아원1996년지2012년공완성6542례복강경담낭절제술( LC)，기중18례발생담관손상，대기원인，손상적부위진행탐토。결과기중해부병리인소10례，조작인소8례。손상부위：담총관11례，간총관5례，우간관2례。14례경중전개복11례행담관수보가T관지탱。3례행담총관공장문합술가지탱。 LC술후인출현담즙성복막염재수술발현담관손상4례，기중담총관손상3례，간총관손상1례。3례행담관수보가T관지탱。1례행담관단단문합술가T관지탱。결론장악호중전개복시궤시피면LC담관손상적중요배절。
Objective To discuss the reason and the methods of treatment for the Bile duct injury(BDI)in laparoscopic cholecystectomy( LC) . Methods To explore the reasons and the places for 18 BDI cases of 6542 in total which were operated be-tween 1996 and 2012 by our hospital. Among them, 18 had bile duct injury, and the paper is going to have a discussion about the reasons for the injury as well as its related lesions. Results It is found that the numbers for anatomy reasons and operation reasons are respectively 10 and 8. Besides, the places for injury are, namely, 11 choledochus injuries, 5 hepatic duct injuries and 2 right he-patic duct injury. 14 cases have been using open cholecystectomy and 11 cases for bile duct repairing which were supported by T channel. Three cases were operated by cholangiojejunstomy. There were 4 cases which were caused by re-operated, three for bile duct injury and one for choleperitionitis. There have been repairing for other 3 cases and T channel were supported for choledochus injury and hepatic duct injury. Conclusion Handling the open cholecystectomy well is the turning point of avoiding LC bile duct Injury.