Bile Duct Injury during Laparoscopic Cholecystectomy:Mechanism of Injury, Prevention, and Treatment
10.3969/j.issn.1009-6604.2014.09.017
- VernacularTitle:腹腔镜胆囊切除术中胆道损伤的原因及防治体会
- Author:
Kefeng WANG
;
Dousheng BAI
- Publication Type:Journal Article
- Keywords:
Laparoscope;
Cholecystectomy;
Bile duct injury
- From:
Chinese Journal of Minimally Invasive Surgery
2014;(9):824-826
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the causes and prevention of bile duct injury during laparoscopic cholecystectomy (LC). Methods Clinical data of 16 cases of bile duct injury during LC between January 2004 and November 2013 (9 cases from Songqiao Central Hospital and 7 cases from Northern Jiangsu People ’ s Hospital ) were analyzed retrospectively .The bile duct injury was found intraoperatively in 10 cases, 4 of which were given common bile duct repaired with T tube drainage , 1 of which was given common bile duct anastomosisd with T tube drainage , 1 of which was given Roux-en-Y anastomosis , and 4 of which were given suturing of leakage at the gallbladder bed .The bile duct injury was found postoperatively in 6 cases, 3 of which were given peritoneal drainage , 2 of which were given reoperation of bile duct repaire with T tube drainage , and 1 of which underwent percutaneous gallbladder drainage guided by B ultrasonography . Results The hospitalization stay was 12-23 days, with an average of 16.3 days.All the patients were cured after treatment .Among the 16 cases of bile duct injury , the T tube was removed 3 months later in 6 cases of common bile duct repaired with T tube drainage , and the T tube removed 6 months later in 1 case of common bile duct anastomosis with T tube drainage.No complications or dysfunctions occurred in postoperative follow-up ranging from 3 months to 8 years. Conclusions We should pay more attention to causes of bile duct injury in laparoscopic cholecystectomy , especially indications for emergency cases .The relationship among the common hepatic duct , common bile duct , and cystic duct should be carefully identified .A timely conversion to open surgery is needed if necessary .
