无胆总管损伤及手术死亡病例。
结论行胆总管下端探查操作应谨慎，避免发生医源性损伤。
Conclusion the distal bile duct exploration should be careful to avoid the iatrogenic injury.
目的探讨医源性胆总管下段或十二指肠后壁意外损伤原因及预防方法。
Objective To investigate the reasons for iatrogenic injury of the distal common bile duct or the posterior wall of duodenum and explore measures for its treatment.
结论常规使用金属胆道探子探查胆道，易导致胆总管下段或十二指肠后壁损伤。
Conclusions Routine use of metal probe for exploration the bile duct may cause injury of common bile duct or the posterior wall of duodenum.
结果：术中造影发现胆囊管变异13例（18%），胆总管结石8例（11.1%），中转开腹3例（4.1%），无胆管损伤。
Results:Intraoperative angiography variation found 13 cases of cystic duct(18%), 8 cases of common bile duct stones(11.1%), three cases of conversion(4.1%), no bile duct injury.
将胆总管横行切断，造成胆管损伤模型。
Then, common bile duct was traversed for the model of bile duct injury.
结论单纯性胆囊切除术中常规经胆囊管造影可发现隐匿性胆总管结石，能有效减少胆管残余结石，减少胆道损伤。
Conclusion Routinal cholangiography through cystic duct in the simple cholecystectomy can find latent stone in the common duct, then reduce residual stone effectively and lessen biliary duct injury.
结果：开腹胆囊切除、胆总管探查及腹腔镜胆囊切除是医源性胆道损伤的主要原因，占87.1%（27/31）。
Results:The main causes for iatrogenic bile duct injury were open cholecystectomy, common bile duct exploration and laparoscopic cholecystectomy, which accounted for 87.1% (27/31).
结果：所有患者均采用此法成功切开及探查胆总管，无邻近脏器损伤，无胆瘘及术后出血，无死亡病例；
ResultsLCDE was successfully performed in all the 75 cases. No patient had complications, such as injury to adjacent organs, bile leakage or postoperative bleeding, and there were no death.
结果：所有患者均采用此法成功切开及探查胆总管，无邻近脏器损伤，无胆瘘及术后出血，无死亡病例；
ResultsLCDE was successfully performed in all the 75 cases. No patient had complications, such as injury to adjacent organs, bile leakage or postoperative bleeding, and there were no death.
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