복강경하 담낭절제술 중 발생한 담관 손상에 대한 임상적 고찰

• Published in: Annals of surgical treatment and research Vol. 71; no. 2; pp. 134 - 138
• Main Authors: 심규범(Gyu Beom Shim), 최인석(In Seok Choi), 고대경(Dea Gyeung Ko), 최원준(Won Joon Choi), 윤대성(Dea Sung Yoon)
• Format: Journal Article
• Language: Korean
• Published: 대한외과학회 01.08.2006
• Subjects: 일반외과학; Cholecystectomy; Laparoscopic surgery; 복강경 수술; Bile duct injury; 담낭절제술; 담관손상
• ISSN: 2288-6575; 2288-6796

Purpose: Laparoscopic cholecystectomy (LC) has become the standard procedure for gallbladder disease. LC is associated with bile duct injury, which can cause serious complications. We evaluate the treatment, results and the relation with cholangiopancreatography for bile duct injury during LC. Methods: 860 cases of LC were performed from April 2000 to August 2005. Among them, 7 cases of bile duct injury were reviewed for the diagnosis, management and operation findings. Results: According to the Strasberg classification, there were 5 cases of type E, 1 case of type C and 1 case of type D. All of them were identified at operation and they were immediately managed. Among the type E cases, the type E1 was managed by CBD end-to-end anastomosis with internal drainage, type the E2 and type E3 were managed by Roux-en-Y hepaticojejunostomy, the type C were managed by primary repair with T-tube drainage and the type D were managed by primary repair. Although all of cases were visible at the cystic duct on preoperative cholangiopancreatography, we could not identify the type E on the operation findings. Conclusion: In this study, although the cystic duct was identified on cholangiopancreatography preoperatively, the possibility of bile duct injury increases if there was severe inflammation and adhesion. For the management of bile duct injury, we recommend CBD end-to-end anastomosis for type E1, Roux-en-Y hepaticojejunostomy for type E2 and E3, and primary repair and/or drainage for type C and D. (J Korean Surg Soc 2006;71:134-138) KCI Citation Count: 0