胆囊四角解剖结构在腹腔镜胆囊切除术中应用体会
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摘要：目的 探索临床胆囊四角的解剖结构，为腹腔镜胆囊切除术提供解剖基础。方法 2010年01月～2013年06月，我科共施行960例良性胆囊腹腔镜胆囊切除术，探索Hartmann袋提起后胆囊三角实际形成临床胆囊四角的组成边界、穿行及毗邻结构。结果 临床胆囊四角由胆囊壶腹后壁、胆囊管、肝总管和肝右叶脏面组成。形成临床胆囊四角的925例(96.35%)，未形成临床胆囊四角的35例(3.65%)。785例(84.86%)胆囊四角内见胆囊动脉，108例(11.68%)胆囊动脉在胆囊管前方经过，17例(1.84%)胆囊动脉在胆囊管下方经过，9例(0.97%)胆囊动脉未见明确解剖，6例(0.65%)胆囊床上见副肝管汇入胆囊肝面。结论 熟悉临床胆囊四角的组成结构及毗邻关系，是减少和避免术中血管和胆管损伤的关键，对降低腹腔镜胆囊切除术的并发症有指导意义。
关键词：胆囊四角；解剖；腹腔镜胆囊切除术
Abstract：Objective Investigate the anatomic structure of Calot's quadrangle during laparoscopic cholecystectomy. Methods 960 benign cholecystitis patients underwent laparoscopic cholecystectomy in our deparment from January 2010 to July 2013. The Calot's triangle was changed into Calot's quadrangle during laparoscopic cholecystectomy. Results Calot's quadrangle was formed by posterior wall of cholecystic ampulla， cystic duct， common hepatic duct and right lobe of liver. Among the 960 patients， Calot's quadrangle were formed in 925 patients(96 ......
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