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胆囊管增粗在腹腔镜胆囊切除术中的处理体会

Management of enlarged cystic duct in laparoscopic cholecystectomy

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【作者】 林森旺孙镇蛟金旭文郑民华

【Author】 Lin Senwang *,Sun Zhenjiao, Jin Xuwen,et al. * Departement of Minimall y Invas iv e Surgery, Shanghai Traditional and Western Medicine Integrated Hospital, Shang hai 200082 , China

【机构】 上海市中西医结合医院微创外科上海第二医科大学附属瑞金医院外科 200082200082200025

【摘要】 目的 探讨腹腔镜胆囊切除术中胆囊管增粗的处理方法。方法 自 2 0 0 1年 3月至 2 0 0 3年 5月 ,对3 1例胆囊管增粗病人行腹腔镜胆囊切除术 ,其中胆囊管直径 0 4~ 0 6cm 2 0例 ,直径 >0 6~ 0 8cm 6例 ,直径 >0 8cm 5例。在腹腔镜胆囊切除术中分别采用阶梯施夹法 (2 2例 )、大号钛夹法 (4例 )、圈套器法 (5例 )三种方法处理胆囊管 ,14例置腹腔引流管。结果  3 0例无并发症治愈出院 ,1例术后第 2天出现胆漏 ,经内镜下逆行胰胆管造影术 (ERCP) +内镜下鼻胆管引流术 (ENBD)及腹腔引流 1个月后治愈出院。结论 在腹腔镜胆囊切除术中 ,应采用适当的方法处理胆囊管增粗

【Abstract】 ObjectiveTo explore the management of enlarged cystic duct in l aparoscopic cholecystectomy.MethodsFrom March 2001 to May 2003 ,31patients w ith enlarged cystic duct underwent laparoscopic cholecystectomy. The diameter o f cystic duct was 0 4- 0 6cm in 20 cases,larger than 0 6- 0 8cm in 6 cases and larger tha n 0 8 cm in 5 cases.Three treatment methods were performed: step claps method (n=22 ),large size endoclip method (n=4) and endoloop method (n=5).And intra- abdominal dr ainage tubes were placed in 14 cases.ResultsThirty patients we re discharged from hospital without complications;1 patient had bile leakage on the 2nd postoperat ive day,who recovered one month later by successful treatment by ERCP, ENB D and intra-abdomina l drainage. ConclusionSuitable methods should be taken to manage enlarged cystic duct in laparoscopic cholecystectomy.

  • 【文献出处】 中国实用外科杂志 ,Chinese Journal of Practical Surgery , 编辑部邮箱 ,2004年03期
  • 【分类号】R657.4
  • 【被引频次】45
  • 【下载频次】148
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