【摘要】 目的:探讨腹腔镜胆管术后胆漏的原因及防治。方法:对2400例腹腔镜胆管术后8例胆漏患者的临床资料进行回顾性分析。结果:6例患者经保守治疗治愈,1例胆囊管钛夹脱落经开腹手术重新结扎胆囊管治愈,1例肝总管损伤致胆漏者经腹腔镜置引流管后胆漏停止,3个月后因肝总管狭窄行胆肠Roux-en-Y吻合术治愈。全部病例随访1￣5年,无胆管并发症发生。结论:肝外胆管或迷走胆管损伤、胆囊管残端钛夹脱落或夹闭不全、T管滑脱或T管窦道未形成是腹腔镜胆管术后胆漏的主要原因,充分引流是治疗的主要手段,但关键在预防。更多还原

【Abstract】 Objective:To investigate the causes, prevention and treatment of bile leakage following laparoscopic biliary tract operation. Methods:Eight bile leakage cases out of 2400 laparoscopic cholecystectomy or laparoscopic common bile duct exploration were retrospectively analyzed.Results:Six patients were cured by conservtive therapy.One patient with clip exfoliation necessited a reexploration by open.One patient with common hepatic duct injury was cured by placing drainage tube through laparoscopic exploration,and received Rou-en-Y choldochojunostomy for common hepatic duct stricture in the third month.All cases were followed up for (1~5) years,and revealed no bile duct complications.Conclusion:Bile duct or aberrant duct injury,clip exfoliation or incomplete,T tube out of common bile duct or the tunnel of T tube incomplete are the causes of bile leakage after laparoscopic biliary tract operation.Patent drainage is the main method in treatment,emphasis should be on the prevention.更多还原