• 1.上海市黃浦區(qū)腫瘤防治院外科(上海200126)2.上海市黃浦區(qū)中心醫(yī)院外科(上海200002)3.哈爾濱醫(yī)科大學(xué)第一臨床醫(yī)學(xué)院普外科(哈爾濱150001);

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. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(2): 166-168. doi: 復(fù)制

版權(quán)信息: ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有,未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

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 management 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.
  1. 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. 2. Champetier J, Létoublon C, Alnaasan I, et al. The cystohepatic ducts: surgical implications [J]. Surg Radiol Anat, 1991; 13(3)∶203.
  3. 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]. 中國普外基礎(chǔ)與臨床雜志, 2001; 8(2)∶88.
  4. 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. 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. 6. Saraswat VA, Choudhuri G, Sharma BC, et al. Endoscopic management of postoperative bile leak [J]. J Gastroenterol Hepatol, 1996; 11(2)∶148.
  7. 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.