Treatment and Analysis on Laparoscopic Bile Duct Injury in Short-term Follow-up:157 Cases Report
LIU Chang-jun1，2，3，HUANG Fei-zhou2，3，YIN Xin-min1，2，MAO Xian-hai1，2，JIANG Bo1，2，ZHOU Hailan1，2，WU Jin-shu1，2
1．Department of Hepatobiliary Surgery，Hunan Provincial People＇s Hospital，Changsha 410005，Hunan，China;2．Hunan Laparoscopic(General Surgery)Treatment Quality Control Center，Changsha 410005，Hunan，China;3．Department of General Surgery，The Third Xiangya Hospital，Central South U-niversity，Changsha 410013，Hunan，China
Abstract: Objective To assess the treatment experience of bile duct injury due to laparoscopic cholecystectomy(LC)．Methods157 cases with bile duct injury due to LC were analyzed retrospectively in our hospital during January 2010 to July 2015．70 cases were found the bile duct injury during the LC and repaired and performed intra-operative end-to-end anastomosis immediately．87 cases were found postoperative obstructive jaundice and bile peritonitis，and were underwent multiple surgeries．ResultsThe causes of bile duct injury were mis-excision or mis-ligation in 88 cases(56．0%)，heat effect injury of electric coagulation of main extrahepatic bile ducts in 33 cases(21．0%)，biliary tract variation in 20 cases(12．7%)and other reasons in 36 cases(22．9%)．In the 55 patients performed basin type of hepatobiliary Roux-en-Y anastomosis，3 cases were found recurrent high stenosis(typeⅣ)and died of biliary cirrhosis，and other 52 cases were cured during the 0．5 to 5(mean 3)years follow-up after the surgery．T tube was i ndwelled in 102 cases and removed3 months later．The bile duct stenosis occurred again and cured by Roux-en-Y choledochojejunostomy in 9 patients during 0．5 to 5 years follow-up．The other 93 cases lived well during 0．5 to 5 years follow-up．ConclusionsThe intra-operative bile duct injury associated with LC always occurred in complex cases．It appeared more difficulty to repair the biliary injury in the case of higher injured site，greater bile duct defect，more detailed bile duct diameter，more severer local inflammation，especially electric knife amputation or burning．Extensive clinical experience，adequate microsurgical consciousness，enough patience and perseverance is the key to successful surgery treatment．
刘昌军1，2，3，黄飞舟2，3，尹新民1，2，毛先海1，2，蒋波1，2，周海兰1，2，吴金术1，2. 腹腔镜胆管损伤157例处理及近期随访分析[J]. 中国现代手术学杂志, 2017, 21(2): 90-93.
LIU Chang-jun. Treatment and Analysis on Laparoscopic Bile Duct Injury in Short-term Follow-up:157 Cases Report. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 90-93.
2017, Vol. 21 
