切换至 "中华医学电子期刊资源库"

中华肝脏外科手术学电子杂志 ›› 2022, Vol. 11 ›› Issue (04) : 338 -341. doi: 10.3877/cma.j.issn.2095-3232.2022.04.003

所属专题: 综述

专家论坛

腹腔镜胆囊切除术致胆管损伤处理方式选择
汪学艳1, 马延龄1, 李海元1, 王云鹏1, 向琳1, 董家鸿2, 陈昊3,()   
  1. 1. 730030 兰州大学第二临床医学院
    2. 100218 北京,清华大学附属清华长庚医院肝胆胰中心
    3. 730030 兰州大学第二医院肿瘤外科 兰州大学第二医院消化系统肿瘤重点实验室
  • 收稿日期:2022-03-16 出版日期:2022-08-10
  • 通信作者: 陈昊
  • 基金资助:
    国家自然科学基金(82160129); 甘肃省重点人才项目(2019RCXM020); 甘肃省科技重大专项(19ZD2WA001); 兰州市城关区科技计划项目(2019RCCX0034,2020JSCX0073,2020SHFZ0039); 兰州大学第二医"萃英科技创新"计划项目(CY2017-ZD01)

Choice of treatments for bile duct injury caused by laparoscopic cholecystectomy

Xueyan Wang1, Yanlin Ma1, Haiyuan Li1   

  • Received:2022-03-16 Published:2022-08-10
引用本文:

汪学艳, 马延龄, 李海元, 王云鹏, 向琳, 董家鸿, 陈昊. 腹腔镜胆囊切除术致胆管损伤处理方式选择[J/OL]. 中华肝脏外科手术学电子杂志, 2022, 11(04): 338-341.

Xueyan Wang, Yanlin Ma, Haiyuan Li. Choice of treatments for bile duct injury caused by laparoscopic cholecystectomy[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2022, 11(04): 338-341.

自1905年Mayo等首次报道使用胆管-十二指肠吻合术修复2例胆囊切除术后胆管损伤(bile duct injury,BDI)后,BDI引起了胆道外科医师的重视[1]。随着微创技术的不断进步,目前已可应用单切口腹腔镜胆囊切除术(LC)和机器人胆囊切除术来修复BDI,但BDI的高发生率仍不可避免,仍有0.4%~0.6%的BDI发生于LC后[1,2]。BDI最佳修复方案应基于患者既往胆道修复手术史、肝脏损害程度及一般情况进行分析,并根据BDI分型系统确定损伤分型、部位、程度和胆道梗阻持续时间进而作出选择。任何类型的修复重建手术最终目的都是恢复胆管的完整性及其连续性,无论采取何种术式进行修复,修复重建的胆管应是无瘢痕、无炎症、血供良好的健康胆管[1,2]

[1]
Feng X, Dong J. Surgical management for bile duct injury[J]. Biosci Trends, 2017, 11(4):399-405.
[2]
Wysocki AP. Population-based studies should not be used to justify a policy of routine cholangiography to prevent major bile duct injury during laparoscopic cholecystectomy[J]. World J Surg, 2017, 41(1):82-89.
[3]
Törnqvist B, Strömberg C, Akre O, et al. Selective intraoperative cholangiography and risk of bile duct injury during cholecystectomy[J]. Br J Surg, 2015, 102(8):952-958.
[4]
Sirinek KR, Schwesinger WH. Has intraoperative cholangiography during laparoscopic cholecystectomy become obsolete in the era of preoperative endoscopic retrograde and magnetic resonance cholangiopancreatography?[J]. J Am Coll Surg, 2015, 220(4):522-528.
[5]
Mazer LM, Tapper EB, Sarmiento JM. Non-operative management of right posterior sectoral duct injury following laparoscopic cholecystectomy[J]. J Gastrointest Surg, 2011, 15(7):1237-1242.
[6]
Barbier L, Souche R, Slim K, et al. Long-term consequences of bile duct injury after cholecystectomy[J]. J Visc Surg, 2014, 151(4):269-279.
[7]
Cai XJ, Ying HN, Yu H, et al. Blunt dissection: a solution to prevent bile duct injury in laparoscopic cholecystectomy[J]. Chin Med J (Engl), 2015, 128(23):3153-3157.
[8]
Fukasawa M, Maguchi H, Takahashi K, et al. Clinical features and natural history of serous cystic neoplasm of the pancreas[J]. Pancreatology, 2010, 10(6):695-701.
[9]
Singh P, Erickson RA, Mukhopadhyay P, et al. EUS for detection of the hepatocellular carcinoma: results of a prospective study[J]. Gastrointest Endosc, 2007, 66(2):265-273.
[10]
Kuroda Y, Tsuyuguchi T, Sakai Y, et al. Long-term follow-up evaluation for more than 10 years after endoscopic treatment for postoperative bile duct strictures[J]. Surg Endosc, 2010, 24(4):834-840.
[11]
Cantù P, Tarantino I, Baldan A, et al. Endo-therapies for biliaryduct-to-duct anastomotic stricture after liver transplantation: outcomes of a nationwide survey[J]. Liver Int, 2019, 39(7):1355-1362.
[12]
Tuvignon N, Liguory C, Ponchon T, et al. Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study[J]. Endoscopy, 2011, 43(3):208-216.
[13]
de Reuver PR, Rauws EA, Vermeulen M, et al. Endoscopic treatment of post-surgical bile duct injuries: long term outcome and predictors of success[J]. Gut, 2007, 56(11):1599-1605.
[14]
Adler DG, Papachristou GI, Taylor LJ, et al. Clinical outcomes in patients with bile leaks treated via ERCP with regard to the timing of ERCP: a large multicenter study[J]. Gastrointest Endosc, 2017, 85(4):766-772.
[15]
Devière J, Nageshwar Reddy D, Püspök A, et al. Successful management of benign biliary strictures with fully covered self-expanding metal stents[J]. Gastroenterology, 2014, 147(2):385-395.
[16]
Wang JX, Zhang Q, Shen WF, et al. Laparoscopic cholecystectomy surgery model's system idea for multi-dimensional multi-angle reduction of bile duct injury: a surgeon's experience[J]. Asian J Surg, 2019, 42(3):524-525.
[17]
Jang SI, Lee KH, Yoon HJ, et al. Treatment of completely obstructed benign biliary strictures with magnetic compression anastomosis: follow-up results after recanalization[J]. Gastrointest Endosc, 2017, 85(5):1057-1066.
[18]
Jang SI, Choi J, Lee DK. Magnetic compression anastomosis for treatment of benign biliary stricture[J]. Dig Endosc, 2015, 27(2):239-249.
[19]
Boulay BR, Lo SK. Endoscopic ultrasound-guided biliary drainage[J]. Gastrointest Endosc Clin N Am, 2018, 28(2):171-185.
[20]
Marino MV, Mirabella A, Guarrasi D, et al. Robotic-assisted repair of iatrogenic common bile duct injury after laparoscopic cholecystectomy: surgical technique and outcomes[J]. Int J Med Robot, 2019, 15(3):e1992.
[21]
张平,李方洪,叶发钧.消化道重建术后肝内外胆管结石经皮经肝胆道镜治疗的临床分析[J/CD].中华普通外科学文献(电子版), 2020, 14(3):204-206, 229.
[22]
Halbert C, Altieri MS, Yang J, et al. Long-term outcomes of patients with common bile duct injury following laparoscopic cholecystectomy[J]. Surg Endosc, 2016, 30(10):4294-4299.
[23]
Ismael HN, Cox S, Cooper A, et al. The morbidity and mortality of hepaticojejunostomies for complex bile duct injuries: a multi-institutional analysis of risk factors and outcomes using NSQIP[J]. HPB, 2017, 19(4):352-358.
[24]
Schreuder AM, Busch OR, Besselink MG, et al. Long-term impact of iatrogenic bile duct injury[J]. Dig Surg, 2020, 37(1):10-21.
[25]
Schmidt SC, Langrehr JM, Hintze RE, et al. Long-term results and risk factors influencing outcome of major bile duct injuries following cholecystectomy[J]. Br J Surg, 2005, 92(1):76-82.
[26]
Schmidt SC, Langrehr JM, Raakow R, et al. Right hepatic lobectomy for recurrent cholangitis after combined bile duct and right hepatic artery injury during laparoscopic cholecystectomy: a report oftwo cases[J]. Langenbecks Arch Surg, 2002, 387(3/4):183-187.
[27]
Karanikas M, Bozali F, Vamvakerou V, et al. Biliary tract injuries after lap cholecystectomy-types, surgical intervention and timing[J]. Ann Transl Med, 2016, 4(9):163.
[28]
Booij KAC, Coelen RJ, de Reuver PR, et al. Long-term follow-up and risk factors for strictures after hepaticojejunostomy for bile duct injury: an analysis of surgical and percutaneous treatment in a tertiary center[J]. Surgery, 2018, 163(5):1121-1127.
[29]
Altieri MS, Yang J, Obeid N, et al. Increasing bile duct injury and decreasing utilization of intraoperative cholangiogram and common bile duct exploration over 14 years: an analysis of outcomes inNew York State[J]. Surg Endosc, 2018, 32(2):667-674.
[30]
Ardiles V, McCormack L, Quiñonez E, et al. Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina: results from a National Survey[J]. HPB, 2011, 13(8):544-550.
[31]
Lubikowski J, Chmurowicz T, Post M, et al. Liver transplantation as an ultimate step in the management of iatrogenic bile duct injury complicated by secondary biliary cirrhosis[J]. Ann Transplant, 2012, 17(2):38-44.
[1] 钟锴, 蒋铁民, 张瑞青, 吐尔干艾力·阿吉, 邵英梅, 郭强. 加速康复外科在肝囊型棘球蚴病肝切除术中的应用分析[J/OL]. 中华普通外科学文献(电子版), 2024, 18(06): 425-429.
[2] 李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[3] 冯旺, 马振中, 汤林花. CT扫描三维重建在肝内胆管细胞癌腹腔镜肝切除术中的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 104-107.
[4] 赖全友, 高远, 汪建林, 屈士斌, 魏丹, 彭伟. 三维重建技术结合腹腔镜精准肝切除术对肝癌患者术后CD4+、CD8+及免疫球蛋白水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 651-654.
[5] 唐梅, 周丽, 牛岑月, 周小童, 王倩. ICG荧光导航的腹腔镜肝切除术临床意义[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 655-658.
[6] 康婵娟, 张海涛, 翟静洁. 胰管支架置入术治疗急性胆源性胰腺炎的效果及对患者肝功能、炎症因子水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[7] 胡森焱, 徐冬, 方健, 谢冬冬, 王财庆. ICG荧光显影Laennec膜入路腹腔镜解剖性肝切除的临床研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 513-516.
[8] 林巧, 周丽. RFA联合LAH术治疗原发性肝癌并门静脉癌栓的临床效果分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 521-524.
[9] 曾繁利, 齐秩凯, 杨贺庆. 两种经Glisson蒂鞘解剖路径肝切除术治疗原发性肝癌的肿瘤学疗效及风险比对[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 525-527.
[10] 张金华, 赵锁. 早期ICC腹腔镜肝切除术不同淋巴结清扫范围的近远期效果对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(05): 578-581.
[11] 焦振东, 惠鹏, 金上博. 三维可视化结合ICG显像技术在腹腔镜肝切除术治疗复发性肝癌中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 859-864.
[12] 吴警, 吐尔洪江·吐逊, 温浩. 肝切除术前肝功能评估新进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 889-893.
[13] 吴雪云, 胡小军, 范应方. 肝切除术中剩余肝再生能力的评估与预测[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 894-897.
[14] 杭轶, 杨小勇, 李文美, 薛磊. 可控性低中心静脉压技术在肝切除术中应用的最适中心静脉压[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 813-817.
[15] 李新宇, 梁建锋. 3D打印导板辅助颅内血肿穿刺引流手术[J/OL]. 中华脑科疾病与康复杂志(电子版), 2024, 14(06): 382-384.
阅读次数
全文


摘要