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,【关键词】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8例LC 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例经迷走胆管漏处再上钛夹后治愈，1例经ENBD治愈;另1例术后发生胆漏、胆汁性腹膜炎，再次经腹腔镜探查并在胆囊壶腹部迷走胆管漏口处上钛夹，并经腹腔引流后治愈。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 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 management of Luschka bile duct injury in laparoscopic cholecystectomy
LI Shaopei,ZHAN Hua,ZENG Shugen,et al.
The People's Hospital of Longquan，Longquan 323700,China
【Abstract】 Objective:To investigate the causes,prevention and managment of Luschka bile duct injury in laparoscopic cholecystectomy (LC).Methods：Retrospectively analyzed the data of 8 cases with the Luschka bile duct injury observed during or after the procedure of LC.Results：7 cases were found during the operation,in which 6 cases were cured by immediate reclipping of Luschka bile duct,and 1 case was cured by ERCP+ENBD.1 case with postoperative bile leakage and biliary peritonitis was cured by laparoscopic exploration and reclipping the injured site of Luschka bile duct in ampulla of gallbladder and abdominal drainage.Conclusions：The key to prevent Luschka bile duct injury and reduce postoperative misdiagnosis is raising the recognition of Luschka bile duct;and the main methods for treating the bile leakage after Luschka bile duct injury in LC include establishing unobstructed abdominal drainage,bile duct drainage and laparoscopic exploration. ......
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