腹腔镜胆囊切除术Luschka胆管损伤的原因及对策
胆囊切除术,腹腔镜;胆管损伤；胆漏,,胆囊切除术，腹腔镜;胆管损伤；胆漏,1资料与方法,2结果,3讨论,参考文献：
【摘要】 目的：探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)Luschka胆管损伤的原因、预防方法及处理措施。方法:回顾性分析LC术中或术后8例Luschka胆管损伤患者的临床资料。结果:术中发现Luschka 胆管损伤7例，其中6例迷走胆管漏处再上钛夹治愈，1例经ENBD治愈;另1例术后胆漏、胆汁性腹膜炎，再次经腹腔镜探查行胆囊壶腹部迷走胆管漏口处上钛夹，腹腔引流治愈。结论：提高对Luschka胆管的认识,是预防迷走胆管损伤和减少术后误诊的关键；建立通畅的腹腔引流、胆管引流、腹腔镜探查是治疗LC术中Luschka胆管损伤后胆漏的主要方法。【关键词】 胆囊切除术，腹腔镜;胆管损伤；胆漏
The causes and handling of Luschka bile duct injury in laparoscopic cholecystectomy
LI Shaopei,ZHAN Hua,ZENG Shugen,et al.
People's Hospital of Longquan City,Zhejiang Province，Longquan 323700,China
【Abstract】 Objective:To discuss the causes,preventive methods,and handling measures of Luschka bile duct injury in laparoscopic cholecystectomy (LC).Methods：Retrospectively analyzed the clinical data of 8 patients with Luschka bile duct injury found during or after the procedure of LC.Results：7 cases with Luschka bile duct injury were found during the operation, among whom 6 cases were cured by immediate reclipping of Luschka bile duct,and 1 case was cured through ERCP+ENBD.Another case combined with postoperative bile leakage and bile peritonitis was cured by laparoscopic exploration and reclipping of Luschka bile duct injury in ampulla of gallbladder,and abdominal drainage.Conclusions：To enrich the knowledge of Luschka bile duct is the key factor to avoid injury,and reduce postoperative misdiagnosis.While the main methods in treating the bile leakage after Luschka bile duct injury during LC include establishing of unobstructed abdominal and bile duct drainage,and laparoscopic exploration. ......
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