Application of Approach of Anterior-Posterior Cystohepatic Triangle in Laparoscopic Cholecystectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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吴文庆 , 刘玉林 , 李小华

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Keywords：

胆囊后三角; 胆囊三角; 腹腔镜胆囊切除术; 象鼻征

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目的探讨联合后-前胆囊三角入路在腹腔镜胆囊切除中的应用价值。方法回顾性分析我院2007年1月至2010年1月期间经联合后-前胆囊三角入路解剖胆囊管及胆囊动脉行腹腔镜胆囊切除的240例患者的临床资料。结果 238例患者安全地完成腹腔镜胆囊切除，术中出血4例，均于镜下止血成功；中转开腹2例。全组无胆管损伤，发生漏胆2例，经引流自愈。结论联合后-前胆囊三角入路解剖胆囊管及胆囊动脉行腹腔镜胆囊切除是一种安全、容易掌握的手术方法。

Citation： 吴文庆,刘玉林,李小华. Application of Approach of Anterior-Posterior Cystohepatic Triangle in Laparoscopic Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(11): 1199-1200. doi: Copy

1.	巴明臣，黄祥成．我国胆道外科的现状及未来 [J]．中国普外基础与临床杂志， 2005； 12(6)： 628-629.
2.	Mühe E． Laparoscopic cholecystectomy-late results [J]． Langenbecks Arch Chir Suppl Kongressbd, 1991: 416-423.
3.	Sváb J, Pesková M, Krska Z, et al． Prevention, diagnosis and treatment of iatrogennic lesions of biliary tract during laparoscopic cholecystectomy. Management of papila injury after invasive endoscopy. Part 1. Prevention and diagnosis of bile duct injuries [J]． Rozhl Chir, 2005; 84(4): 176-181.
4.	陈颢，田建伟，李建华．腹腔镜胆囊切除手术前后肝外胆管直径变化的临床研究 [J]．中国普外基础与临床杂志， 2008； 15(10): 768-770.
5.	Sinha R． Early laparoscopic cholecystectomy in acute biliary pancreatitis: the optimal choice? [J]． HPB (Oxford), 2008; 10(5): 332-335.
6.	Yaghoubian A, Saltmarsh G, Rosing DK. Decreased bile duct injury rate during laparoscopic cholecystectomy in the era of the 80-hour resident workweek [J]． Arch Surg, 2008; 143(9): 847-851.
7.	Thurley PD, Dhingsa R. Laparoscopic cholecystectomy: postoperative imaging [J]． AJR Am J Roentgenol, 2008; 191(3): 794-801.
8.	de Reuver PR, Sprangers MA, Rauws EA, et al． Impact of bile duct injury after laparoscopic cholecystectomy on quality of life: a longitudinal study after multidisciplinary treatment[J]． Endoscopy, 2008; 40(8): 637-643.
9.	Traverso LW. Risk factors for intraoperative injury during cholecystectomy: an ounce of prevention is worth a pound of cure [J]． Ann Surg, 1999; 229(4): 458-459.
10.	王俭，范明，修瑞龄，等．丝线结扎胆囊颈管和胆囊动脉在LC中的应用 [J]．中国普外基础与临床杂志, 2006； 13(4)： 459-460.
11.	潘雷．三孔法腹腔镜胆囊切除术106例体会 [J]．中国普外基础与临床杂志， 2006； 13(6)： 713-714.
12.	周新华，李宏，陆才德，等．腹腔镜胆囊切除术中预防胆管损伤的经验(附2 694例报告) [J]．中国普外基础与临床杂志， 2003； 10(5)： 499-500.
13.	黎前德，杨培, 王东，等． 13 840例腹腔镜手术临床分析 [J]．中国普外基础与临床杂志， 2005； 12(6)： 554-557.
14.	尹耀新, 殷良春, 熊沛, 等．腹腔镜胆囊切除术中胆囊壶腹后开窗法预防胆道损伤的体会 [J]．腹腔镜外科杂志， 2008; 13(1)： 75-77.
15.	游晓功，袁克美．胆囊后三角的解剖及其在腹腔镜胆囊切除术中的临床意义 [J]．解剖学杂志， 2008; 31(1)： 118-120.
16.	雷海录, 雷莹, 于颖, 等．腹腔镜胆囊切除术21 694例分析 [J]. 第四军医大学学报, 2009; 30(3): 220.

1. 巴明臣，黄祥成．我国胆道外科的现状及未来 [J]．中国普外基础与临床杂志， 2005； 12(6)： 628-629.
2. Mühe E． Laparoscopic cholecystectomy-late results [J]． Langenbecks Arch Chir Suppl Kongressbd, 1991: 416-423.
3. Sváb J, Pesková M, Krska Z, et al． Prevention, diagnosis and treatment of iatrogennic lesions of biliary tract during laparoscopic cholecystectomy. Management of papila injury after invasive endoscopy. Part 1. Prevention and diagnosis of bile duct injuries [J]． Rozhl Chir, 2005; 84(4): 176-181.
4. 陈颢，田建伟，李建华．腹腔镜胆囊切除手术前后肝外胆管直径变化的临床研究 [J]．中国普外基础与临床杂志， 2008； 15(10): 768-770.
5. Sinha R． Early laparoscopic cholecystectomy in acute biliary pancreatitis: the optimal choice? [J]． HPB (Oxford), 2008; 10(5): 332-335.
6. Yaghoubian A, Saltmarsh G, Rosing DK. Decreased bile duct injury rate during laparoscopic cholecystectomy in the era of the 80-hour resident workweek [J]． Arch Surg, 2008; 143(9): 847-851.
7. Thurley PD, Dhingsa R. Laparoscopic cholecystectomy: postoperative imaging [J]． AJR Am J Roentgenol, 2008; 191(3): 794-801.
8. de Reuver PR, Sprangers MA, Rauws EA, et al． Impact of bile duct injury after laparoscopic cholecystectomy on quality of life: a longitudinal study after multidisciplinary treatment[J]． Endoscopy, 2008; 40(8): 637-643.
9. Traverso LW. Risk factors for intraoperative injury during cholecystectomy: an ounce of prevention is worth a pound of cure [J]． Ann Surg, 1999; 229(4): 458-459.
10. 王俭，范明，修瑞龄，等．丝线结扎胆囊颈管和胆囊动脉在LC中的应用 [J]．中国普外基础与临床杂志, 2006； 13(4)： 459-460.
11. 潘雷．三孔法腹腔镜胆囊切除术106例体会 [J]．中国普外基础与临床杂志， 2006； 13(6)： 713-714.
12. 周新华，李宏，陆才德，等．腹腔镜胆囊切除术中预防胆管损伤的经验(附2 694例报告) [J]．中国普外基础与临床杂志， 2003； 10(5)： 499-500.
13. 黎前德，杨培, 王东，等． 13 840例腹腔镜手术临床分析 [J]．中国普外基础与临床杂志， 2005； 12(6)： 554-557.
14. 尹耀新, 殷良春, 熊沛, 等．腹腔镜胆囊切除术中胆囊壶腹后开窗法预防胆道损伤的体会 [J]．腹腔镜外科杂志， 2008; 13(1)： 75-77.
15. 游晓功，袁克美．胆囊后三角的解剖及其在腹腔镜胆囊切除术中的临床意义 [J]．解剖学杂志， 2008; 31(1)： 118-120.
16. 雷海录, 雷莹, 于颖, 等．腹腔镜胆囊切除术21 694例分析 [J]. 第四军医大学学报, 2009; 30(3): 220.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Approach of Anterior-Posterior Cystohepatic Triangle in Laparoscopic Cholecystectomy

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