腹腔镜下胆囊切除术致胆道损伤临床分析.docVIP

腹腔镜下胆囊切除术致胆道损伤临床分析 　　【摘要】 目的：探讨腹腔镜下胆囊切除术致胆道损伤的临床情况。方法：选取本院2010年2月-2013年6月普外科收治的腹腔镜下胆囊切除术致胆道损伤患者30例作为胆道损伤组，同时选取同期腹腔镜下胆囊切除术无胆道损伤患者200例作为对照组。采用单因素分析和多因素回归分析，总结胆道损伤的原因。结果：结果表明，两组患者术者、胆道异常结构、胆囊壁厚度、胆囊管长度、术中粘连、术中出血、胆囊管切断顺序比较差异均有统计学意义（P0.05），多因素回归分析可知，术者、胆道异常结构、胆囊管长度、术中粘连、术中出血、胆囊管切断顺序均是胆道损伤的危险因素（P0.05）。结论：术者熟练操作，掌握胆道异常结构、胆囊管长度、术中粘连、术中出血、胆囊管切断顺序等情况，可以降低胆道损伤的风险性。 　　【关键词】 腹腔镜下胆囊切除术； 胆道损伤； 多因素回归分析 　　Clinical Analysis of Biliary Injury Caused by Laparoscopic Cholecystectomy/HU Li-chun，ZHAO Hai-sheng，ZHANG Ming-yi.//Medical Innovation of China，2015，12（20）：147-149 　　【Abstract】 Objective：To investigate the clinical setting of biliary injury caused by laparoscopic cholecystectomy.Method：30 patients with biliary injury caused by laparoscopic cholecystectomy in general surgery department of our hospital from February 2010 to June 2013 were selected as the biliary injury group，then 200 patients laparoscopic cholecystectomy without biliary injury were selected as the control group.The causes of biliary injury were summarized using single factor analysis and multifactor regression analysis.Result：The results suggested that there were statistically significant differences in the performer，biliary abnormal structure，gallbladder wall thickness，cystic duct length，intraoperative adhesion，hemorrhage during operation，the order of cystic duct to cut off between the two groups（P0.05），multifactor regression analysis showed that，the performer，biliary abnormal structure，cystic duct length，intraoperative adhesion，hemorrhage during operation，the order of cystic duct to cut off were risk factors for biliary injury（P0.05）.Conclusion：The performer for skilled operation，master the biliary abnormal structure，cystic duct length，intraoperative adhesion，hemorrhage during operation，the order of cystic duct to cut off，which can reduce the risk of biliary injury. 　　【Key words】 Laparoscopic cholecystectomy； Biliary injury； Multifactor regression analysis 　　First-author’s address：The Third People’s Hospital