目的 探討膽囊切除術(shù)時(shí)Luschka膽管損傷的診斷及處理。
方法 回顧性分析2 039例膽囊切除術(shù)中26例Luschka膽管損傷的情況。
結(jié)果 26例中15例于術(shù)中發(fā)現(xiàn)膽漏點(diǎn)，行縫扎止漏成功，5例行縫扎失敗者和3例未找到膽漏點(diǎn)者，經(jīng)引流后痊愈。術(shù)后發(fā)現(xiàn)3例，其中1例經(jīng)鼻膽管引流治愈； 1例經(jīng)再手術(shù)引流治愈； 1例再手術(shù)后發(fā)生心肌梗塞死亡。
結(jié)論 膽囊切除術(shù)時(shí)Luschka膽管損傷較難避免，術(shù)中發(fā)現(xiàn)并及時(shí)治療效果最好； 術(shù)后發(fā)現(xiàn)應(yīng)及時(shí)行剖腹探查和充分引流。
引用本文： 楊新平,黃衛(wèi)民,金榮,朱上林,姜洪池. Luschka膽管損傷的診斷與處理. 中國(guó)普外基礎(chǔ)與臨床雜志, 2004, 11(2): 166-168. doi: 復(fù)制
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- 1. McQuillan T, Manolas SG, Hayman JA, et al. Surgical significance of the bile duct of Luschka [Ｊ]. Br J Surg, 1989; 76(7)∶696.
- 2. Champetier J, Létoublon C, Alnaasan I, et al. The cystohepatic ducts: surgical implications [Ｊ]. Surg Radiol Anat, 1991； 13(3)∶203.
- 3. 舒曄, 周總光, 解蓉, 等. 腹腔鏡膽囊切除術(shù)細(xì)小膽管損傷的診斷與處理 [Ｊ]. 中國(guó)普外基礎(chǔ)與臨床雜志, 2001； 8(2)∶88.
- 4. Albishri SH, Issa S, Kneteman NM, et al. Bile leak from duct of Luschka after liver transplantation [Ｊ]. Transplantation, 2001; 72(2)∶338.
- 5. McMahon AJ, Fullarton G, Baxter JN, et al. Bile duct injury and bile leakage in laparoscopic cholecystectomy [Ｊ]. Br J Surg, 1995; 82(3)∶307.
- 6. Saraswat VA, Choudhuri G, Sharma BC, et al. Endoscopic management of postoperative bile leak [Ｊ]. J Gastroenterol Hepatol, 1996; 11(2)∶148.
- 7. Azagra JS, De Simone P, Goergen M. Is there a place for laparoscopy in management of postcholecystectomy biliary injuries? [Ｊ]. World J Surg, 2001; 25(10)∶1331.