CAJ | 학술논문

探讨腹腔镜胆囊切除术中副肝管损伤的预防和处理.回顾性分析8例腹腔镜胆囊切除术(LC)术中、术后发现合并副肝管损伤患者的临床资料.4例Ⅰ型副肝管损伤患者中,3例术中发现并处理,1例术后再次行腹腔镜处理;Ⅱ、Ⅲ、Ⅳ型副肝管损伤共4例,术中发现后分别处理.提示为防止腹腔镜胆囊切除术中损伤副肝管,应熟悉副肝管各种类型,警惕副肝管“二次损伤”.损伤的副肝管直径＜2 mm可直接夹闭,直径≥3 mm的副肝管损伤,须进行有效引流.
탐토복강경담낭절제술중부간관손상적예방화처리.회고성분석8례복강경담낭절제술(LC)술중、술후발현합병부간관손상환자적림상자료.4례Ⅰ형부간관손상환자중,3례술중발현병처리,1례술후재차행복강경처리;Ⅱ、Ⅲ、Ⅳ형부간관손상공4례,술중발현후분별처리.제시위방지복강경담낭절제술중손상부간관,응숙실부간관각충류형,경척부간관“이차손상”.손상적부간관직경＜2 mm가직접협폐,직경≥3 mm적부간관손상,수진행유효인류.
To explore the prevention and management of accessory hepatic duct (AHD) injury during laparoscopic cholecystectomy (LC).Four cases of type Ⅰ AHDs were found in our series.In three cases,the injured ADHs were clipped by Hemolock during LC while another case was sutured during laparoscopic re-operation.Four cases of type Ⅱ,Ⅲ,Ⅳ AHDs injury were found and treated by different intraoperative methods.Conclusion for preventing AHD injury during LC,anatomic identification is essential for surgeons.A small AHD (＜2 mm) injury may be treated by clipping or suturing while a large AHD (＞ 3 mm) injury requires an effective drainage.