腹腔镜胆囊切除术中胆囊动脉出血的原因及处理对策

蔡泽平 吴青松 张勤俭 2005-12-13 13:10:48 中华中西医杂志 2004年8月第5卷第15期

    【摘要】 目的 探讨腹腔镜胆囊切除术中胆囊动脉出血原因及处理对策。方法 回顾性分析18例腹腔镜胆囊切除术中发生胆囊动脉出血原因、处理方法及效果。结果 术中因游离、剪断胆囊管时损伤胆囊动脉9例（50%），分离胆囊床时损伤胆囊动脉分支出血4例（22.2%），胆囊变异血管出血3例（16.7%），胆囊穿支血管出血2例（11.1%），处理方法采用钛夹钳夹、电凝止血，全组病例无中转开腹，术后未发生继发出血，无胆管损伤。结论 胆囊动脉出血是腹腔镜胆囊切除术术中出血的常见原因，只要术者掌握腹腔镜手术技巧及相应处理对策，均能获到满意的效果。

    关键词 腹腔镜胆囊切除术 出血

    Management and cause of cystic artery bleeding during  laparoscopic cholecystectomy

 

    Cai Zeping，Wu Qingsong，Zhang Qinjian

    Department of General Surgery，Chenzhou Railway Hospital，Hunan423000.

    【Abstract】 Objective To investigate the causes and managements of cystic artery bleeding during laparoˉscopic cholecystectomy（LC）.Methods Causes，alternative of managements and results of18cases with cystic artery bleeding following LC were retrospectively analysed.Results 9cases（50%）of cystic artery injury result from cutˉting or dissecting cystic duct intraoperatively，4cases（22.2%）of branches of cyctic artery injury close to the gallbladˉder bed，and3cases（16.7%）and2cases（11.1%）results from variant and perforating branches of cystic artery reˉspectively.Titanium clips and electric coagulation were utilized to stop bleeding and got a better effects.Neither paˉtients transformed to open surgery during operation nor rebleeding or biliary injury during operation or in the late postˉoperative period.Conclusion Mastering proficient laparoscopic technology and managemant to a surgeon is bound to obtain satisfactory results.      Key words laparoscopic cholecystectomy hemorrhage