摘要
目的探讨腹腔镜胆囊切除术（LC）中如何避免变异右后肝管损伤及损伤后的处理。方法我院2011年1月至2013年11月共进行Lc1710例。其中5例发现右后肝管变异。本文对其进行总结分析。结果术中发现右后肝管汇入胆囊体部1例（ⅠA型），右后肝管汇入胆囊管2例（ⅢA型），胆囊管汇人右后肝管2例（ⅢB型），变异以Ⅲ型多见。全组5例患者均未造成胆管损伤，其中1例中转开腹后行胆囊切除。结论右后肝管变异是LC中胆管损伤的重要原因。充分认清右后肝管变异的类型，合理实施术前MRCP及术中胆道造影，掌握合适的手术方法及技巧，可有效预防变异右后肝管损伤。
Objective To investigate how to avoid and deal with injuries to the aberrant right posterior hepatic duct during laparoscopic cholecystectomy （LC）. Method We studied 1 710 patients who underwent LC in our unit from January 2011 to November 2013. There were 5 patients with right posterior hepatic duct abnormally, and this paper analysed the cases. Results In the 5 patients, one patient had the fight posterior hepatic duct draining into the gallbladder body （ Ⅰ A type）, two patients had the fight posterior hepatic duct draining into the cystic duct （ Ⅲ A type）, and two patients had the cystic duct draining into the right posterior hepatic duct （ Ⅲ B type）. There was no damage to the right posterior hepatic duet during operation. One patient was converted from LC to open operation. The major aberrance was class Ⅲ. Conclusions Variant bile duct is an important cause of bile duct injuries during LC. The fight posterior hepatic duct variation is the most common form. To raise our vigilance and fully understand the types of aberrant right posterior hepatic duct, reasonable use of preoperative MRCP and intraoperative cholangiography in selected patients are fundamental. Aberrant right posterior hepatic duet injuries can effectively be avoided.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2014年第5期359-362,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胆囊切除术
腹腔镜
胆管变异
肝管损伤
Cholecystectomy,laparoscopic
Bile duct variation
Hepatic duct injury
