胆囊切除后胆瘘和出血与胆囊床组织学的关系

被引：36

作者：

刘德辉 ^{[1
]}

潘瑞芹 ^{[1
]}

贾振庚 ^{[1
]}

徐邦宁 ^{[2
]}

陆敬国 ^{[2
]}

王跃 ^{[2
]}

张晶 ^{[2
]}

机构：

[1] 中日友好医院普外科

[2] 中日友好医院病理科

来源：

中华外科杂志 | 1990年 / 11期

关键词：

胆囊切除术; 手术后并发症; 胆瘘; 出血;

D O I：

暂无

中图分类号：

R657 [];

学科分类号：

1002 ; 100210 ;

摘要：

作者分析了303例胆囊切除的胆囊床并发症:胆瘘22例(7.2%),胆瘘所致腹腔感染3例(0.9%);大出血5例(1.7%),出血导致死亡2例(0.7%)。60具尸体的胆囊床行组织切片显微镜下观察,其主要结构为:(1)胆囊床的结缔组织内含有大量胶原纤维、网状纤维和弹力纤维,紧贴于肝表面,本文称之为"纤维膜"(2)有丰富的小动、静脉和淋巴管等;(3)有较多的来自肝小叶的小胆管。由于手术损伤了胆囊床的小胆管和小血管是术后并发胆瘘和出血的原因。术后肝下放胶管引流和术中保留纤维膜的完整,并对出血点逐一缝扎是防治术后胆瘘和大出血的根本措施。

引用

页码：665 / 667 +702-703+707

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