目的 探讨如何有效防止行腹腔镜胆囊切除术（LC）中肝外胆管损伤的发生。方法 2006年9月~2015年1月对8000名胆囊结石（急性期或慢性期）、胆囊息肉、瓷性胆囊、胆囊壁增厚、胆囊腺肌症，胆囊癌等患者行腹腔镜胆囊切除术。对其中发生肝外胆管损伤的患者进行回顾性分析。
结果 发生肝外胆管损伤15例，发生率为0.13%。经治疗后全部治愈出院，随访恢复良好。结论 腹腔镜胆囊切除手术中需要认真解剖，不能盲目离断管道；及时发现肝外胆管损伤，争取在术中得到正确的处理，以避免术后并发症的发生。
Objective: Prevation the incidence of Bile duct injury in the laparoscopic cholecystectomy.Methods: During September 1991 to today， 11000 LCs were preformed and 15 cases were diagnosed in bile duct injure during the operation and received corresponding treatment.Result: The mean follow-up period after surgery was 5-10 years，all bile duct injury patients were fine.Conclusions:We should correctly handle the relationship of various duct and avoid burn or cut duct for reducing incidence of the extrahepatic bile duct damage. Correctly treatment can reduce or avoid the incidence of postoperative complications.
1.吴伟,张存.腹腔镜胆囊切除术相关胆道损伤12例诊治分析.陕西医学杂志,2013,42(6):687-688.
2.LovecekM,HavlíkR,KleinJ,etal.Iatrogenic bile ducts injuries.RozhlChir, 2010, 89(3):183 -187.
3.Al-Kubati WR. Bile duct injuries following laparoscopic cholecystectomy:A clinicalstudy.SaudiJGastroenterol, 2010, 16(2):100 -104.
4. 中华医学会外科学分会胆道外科学组. 胆管损伤的诊断和治疗指南[J]. 中华消化外科杂志, 2013, 12(2): 81-95.
5. 杨学斌.腹腔镜胆囊切除术3512例疗效分析.中国当代医药,2012,5(14):186-187.
6.谷化剑,冯贤松,辛小燕.医源性胆道损伤的原因分析与防治策略. 中国普通外科杂志,2013,22(2):192-196.
7. Johnson SR，Koehler A，Pennindlou LK，etal．Longtermrelts of surgical repair of hile duct injuries following laparos copic cholecy stectomy［J］． Surg，2000，128(4):667－668.
8. 蔡秀军，顾晓静，等。冲吸钝性解剖法显露肝总管防止腹腔镜胆囊切除术中胆道损伤。中华医学杂志，2007,87:1425-1426.
9. Haglund U, Norén A. Routine intraoperative cholangiography
in elective laparoscopic cholecystectomy [J]. Scand J Surg,2010, 99(4): 195-196.
10. Lau WY，Lai EC，Lau SH. Management of bile duct injury after laparoscopic cholecystectomy：a review[J]. ANZJ Surg，2010，80（1）：75-81.
