影响腹腔镜胆囊切除术胆管损伤的相关危险因素研究

被引：31

作者：

龙胜林

杨华

顾超

唐海静

舒易超

机构：

[1] 贵阳医学院附属黔东南州人民医院肝胆外科

来源：

重庆医学 | 2015年 / 44卷 / 02期

关键词：

胆囊切除术,腹腔镜; 胆管疾病; 创伤和损伤; 危险因素;

D O I：

暂无

中图分类号：

R657.4 [胆囊、胆管];

学科分类号：

100408 [卫生政策与卫生管理学];

摘要：

目的探讨腹腔镜胆囊切除术并发胆管损伤的相关危险因素,以减少胆管损伤的发生率,改善患者预后。方法察看2003年12月至2013年12月在该院行腹腔镜胆囊切除手术的1 244例患者的病历及病程记录。对患者性别、年龄、行LC术时间、病理、胆囊壁厚度、术前肝功水平、是否存在胆囊三角解剖异常情况和医师经验等因素与LC并发胆管损伤的相关性进行Logistic回归分析。结果 LC手术时间早、急性胆囊炎患者、合并胆囊积液的胆结石患者、胆囊壁厚度大于4mm、胆囊三角解剖存在变异情况和医师经验不足是LC手术并发胆管损伤的高危险因素(P<0.05)。结论针对LC并发胆管损伤的高危因素,术中采用合理手段降低胆管损伤的发生率,术后积极交流学习增加医师LC术的技巧与经验。

引用

页码：224 / 225+228 +228

页数：3

共 13 条

[1]

腹腔镜胆道损伤的风险因素和处理方法 [J].

徐小东 ;

李徐生 .

中国微创外科杂志, 2009, 9 (07) :663-665

[2]

腹腔镜胆囊切除术胆管损伤的防治体会 [J].

王强 ;

游海波 ;

张涛 ;

余和兵 .

重庆医学, 2008, (17) :1982-1983

[3]

Threefold increased bile duct injury rate is associated with less surgeon experience in an insurance claims database [J].

Schwaitzberg, Steven D. ;

Scott, Daniel J. ;

Jones, Daniel B. ;

McKinley, Sophia K. ;

Castrillion, Johanna ;

Hunter, Tina D. ;

Brunt, L. Michael .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2014, 28 (11) :3068-3073

[4]

The Management of a Complex Bile Duct Injury after Laparoscopic Cholecystectomy [J].

Laux, Anne T. ;

Testa, Giuliano ;

Goldstein, Robert M. ;

Cavaness, Keith M. .

AMERICAN SURGEON, 2014, 80 (06) :E175-E178

[5]

History of Biliary Surgery [J].

Yannos, Spirou ;

Athanasios, Petrou ;

Christos, Christoforides ;

Evangelos, Felekouras .

WORLD JOURNAL OF SURGERY, 2013, 37 (05) :1006-1012

[6]

Iatrogenic biliary injury: 13,305 cholecystectomies experienced by a single surgical team over more than 13 years [J].

Tantia, O. ;

Jain, M. ;

Khanna, S. ;

Sen, B. .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2008, 22 (04) :1077-1086

[7]

Common sense and common bile duct injury: common bile duct injury revisited [J].

Vazquez, Richard M. .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2008, 22 (08) :1743-1745

[8]

Risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy [J].

Simopoulos, C ;

Botaitis, S ;

Polychronidis, A ;

Tripsianis, G ;

Karayiannakis, AJ .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2005, 19 (07) :905-909

[9]

Randomized clinical trial of open versus laparoscopic cholecystectomy in the treatment of acute cholecystitis.[J].M.Johansson;A.Thune;L.Nelvin;M.Stiernstam;B.Westman;L.Lundell.Br J Surg.2004, 1

[10]

A nationwide study of conversion from laparoscopic to open cholecystectomy [J].

Livingston, EH ;

Rege, RV .

AMERICAN JOURNAL OF SURGERY, 2004, 188 (03) :205-211

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