腹腔镜胆囊切除手术胆漏的防治
胆囊切除术,腹腔镜；胆漏；并发症,,胆囊切除术，腹腔镜；胆漏；并发症,1临床资料,2结果,3讨论,参考文献：
【摘要】 目的：探讨预防腹腔镜胆囊切除术(laparoscopic cholecystectomy，LC)胆漏的有效措施。方法：对我院2000年1月至2006年1月512例LC术发生胆漏8例(1.56%)的原因进行回顾和分析。结果：8例患者全部治愈，2例经过非手术治愈，占25%，2例行再次腹腔镜探查，占25%，4例开腹探查手术，占50%。结论：严格掌握LC手术适应证，良好显露Calot三角，靠胆囊钝性分开Calot三角，认准胆囊壶腹与胆囊管交汇部并游离出其延伸段是确认胆囊管的可行方法，适时把握中转开腹手术时机是预防胆漏等并发症的关键。【关键词】 胆囊切除术，腹腔镜；胆漏；并发症
The prevention of biliary fistula during laparoscopic cholecystectomy
LIU Tianxue,XU Changqing,ZHANG Guiru,et al.
Department of General Surgery,the People's Hospital of Penglai,Penglai 265600,China
【Abstract】 Objective:Accidental biliary fistula may occur during laparoscopic cholecystectomy(LC).The prevention measures were investigated in this report.Methods:The study were based on retrospective review of 8 cases biliary fistula within past 6 years out of 512 LC in our unit from January 2000 to January 2006.Results:8 patients had healed.Two(25%) cases healed without operation.Two(25%) cases healed without operation.Two(25%) cases underwent laparoscopic again.Four(50%) cases underwent laparotomy.Conclusions:It must grasp indication of laparoscopic cholecystectomy strictly.Tactics to avoid such accident were summed as follows:properly exposing the Calot's triangle,carefully disecting the connecting site of cystic ampulla and cystic duct.It is the key step of grasping proper occasion of transfer to laparotomize.It is the key step to prevent complications such as biliary fistula,too. ......
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