[1]王怀志,苑军正**,汪海,等.腹腔镜胆囊切除术后黄疸的处理及分析[J].中国微创外科杂志,2016,16(12):1140-1142.
　Wang Huaizhi,Yuan Junzheng,Wang Hai,et al.Treatment and Analysis of Jaundice After Laparoscopic Cholecystectomy[J].Chinese Journal of Minimally Invasive Surgery,2016,16(12):1140-1142.
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腹腔镜胆囊切除术后黄疸的处理及分析()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
16
期数:
2016年12期
页码:
1140-1142
栏目:
经验交流
出版日期:
2016-12-20

文章信息/Info

Title:
Treatment and Analysis of Jaundice After Laparoscopic Cholecystectomy
作者:
王怀志; 苑军正**; 汪海; 石献洲
武警河南总队医院普外科，郑州450052
Author(s):
Wang Huaizhi;  Yuan Junzheng;  Wang Hai;  et al.
Department of General Surgery, Henan Hospital of Chinese People’s Armed Police Force, Zhengzhou 450052, China
关键词:
腹腔镜胆囊切除术; 黄疸; 并发症
Keywords:
Laparoscopic cholecystectomy; Jaundice; Complication
文献标志码:
B
摘要:
目的探讨腹腔镜胆囊切除(laparoscopic cholecystectomy，LC)术后黄疸的原因及处理方法。方法回顾性分析2010年3月~2015年3月51例LC术后黄疸的临床资料，以超声、CT、磁共振胰胆管造影或经内镜逆行胰胆管造影诊断，其中胆总管结石残留35例，胆总管损伤11例，肝细胞性黄疸2例，十二指肠乳头出口狭窄3例（炎性狭窄2例，十二指肠乳头腺癌1例），采用十二指肠镜下取石27例，十二指肠镜下造影或活检4例，腹腔镜手术3例，开腹手术17例。结果51例手术均成功，术后10~15 d出院，无死亡病例。结论LC术后黄疸原因较多，在诊断过程中，应结合病人具体情况，分析具体原因，采用个体化处理。
Abstract:
ObjectiveTo investigate the causes and treatment of jaundice after laparoscopic cholecystectomy (LC). MethodsClinical data of 51 patients with jaundice after LC from March 2010 to March 2015 were retrospectively analyzed in our hospital. According to the diagnosis of ultrasound, CT scanning, magnetic resonance imaging and endoscopic retrograde cholangiopancreatography, there were 35 cases of residual common bile duct stones, 11 cases of common bile duct injury, 2 cases of hepatocellular jaundice, 3 cases of duodenal papilla outlet stenosis (inflammatory stenosis in 2 cases and duodenal papilla adenocarcinoma in 1 case). Treatment included 27 cases of duodenal endoscopy, 4 cases of duodenal endoscopy or biopsy, 3 cases of laparoscopic operation and 17 cases of open surgery.ResultsThe operations were performed successfully in all the 51 cases. The patients were discharged from hospital at 10-15 postoperative days. No fatal case happened. ConclusionsReasons of jaundice after LC are different. It is necessary to analyze and deal with individual case. We should combine and analyze with the specific circumstances in the process of diagnosis.

参考文献/References:

[1]朱琳,赵建锋,史维,等.腹腔镜胆囊切除术后黄疸的预防和处理.肝胆外科杂志,2012,20(4)：315-316.
[2]苑军正,赵国强.三镜联合治疗胆道结石988例临床观察.中华普外科手术学杂志:电子版,2015,9(1):35-38.
[3]杨兴建,康欣,赵良松,等.腹腔镜胆囊切除术后黄疸的诊治体会.中国医药指南,2014,12(35):15-16.
[4]杨兴建.腹腔镜胆囊切除术中转开腹的临床分析.腹腔镜外科杂志,2013,18(3):208-210.
[5]陈永生,田雨,吴硕东,等.Oddi’s扩约肌功能异常的诊断与治疗决策.肝胆外科杂志,2010,18(2):91-92.

备注/Memo

备注/Memo:
武警部队科学技术进步奖(2012-3-37-1)**通讯作者，E-mail：yuanjunzhenghuo@163.com
更新日期/Last Update: 2017-03-09