腹腔镜胆囊切除术后迟发性胆漏的发生机制及预防-中华肝胆外科杂志.PDF

·521· 生堡赶胆窆￡型盘查!!!!生!旦箜!!鲞箜!翅坠i望!旦12111垒i!i!型坠堡!垒骘!!!!!y!!：!；!塑!：! ·论著· 腹腔镜胆囊切除术后迟发性胆漏的 发生机制及预防措施 李虎城刘吉奎邹一平 李为民黄辉王庆松谢文刚 【摘要】 目的探讨腹腔镜胆囊切除术(Lc)后迟发性胆漏的发生机制、处理方法及预防措施。 方法对LC后出现迟发性胆漏的1l例病人的发病特点、发生机制、处理方法及预后进行回顾性分 析。结果经不同的手术和介入治疗后，所有病人均痊愈出院，无死亡率。平均住院11d，无腹腔出 血、感染等并发症出现；复查B超或造影显示胆道无狭窄、扩张，造影剂排泄通畅，生活质量良好。结 论LC后迟发性胆漏有其特定的发生机制，是可以减少或避免的；内镜和介入治疗效果良好，具有其 独到的优势。 【关键词】腹腔镜术； 迟发性胆漏； 内镜治疗 Mechanismsofand measuresfor bile after LI preventive delayedleakagelaparoscopiccholecystectomy ofHepatobiliary Clinical Hucheng’，LIUJikui，ZOUYiping，eta1．。Department Surgery，309 Division．General0f 100091，P．R．China HospiralPLA，Beijing To themechanismsandtreatmentand measuresfor [Abstract] of Objectivestudy preventive bile after Theclinicaldataof11 cases delayedleakagelaparoscopiccholecysteetomy(LC)．Methods of bile afterLCwere After or delayedleakage retrospectivelyanalyzed．Resultsoperation，endoscopic interventionaltreatments。allthe11 recoveredandnoneofthemdied．Themean patientscompletely durationof was11 d．No suchas andinfeetion in hospitalization complicationsbleeding etc．appeared these and examinationshowedthattherewerenostricture patients．t3-modeultrasonographyX-ray and in The bile LC mecha— extensionthebileduct．Conclusions afterhasits delayedleakage special nismanditcanbereducedand andinterventionaltreatmentsareof ad— avoided．Endoscopic particular for ofthe bile af