肝胆胰外科杂志2026，Vol.38Issue(5)：325-331,7.DOI:10.11952/j.issn.1007-1954.2026.05.004
"伪三角"异常解剖认知在腹腔镜胆囊切除术胆管横断损伤预防中的临床应用
The correct understanding of"pseudo-triangle"anatomical abnormalities can reduce the incidence of bile duct transection injury during laparoscopic cholecystectomy
程祥云 1冯志宏 1李坚 1王良波 1魏恒明 1曹钰 1郭兵 1李明月 1刘宇 1阿木金刚1
作者信息
- 1. 川北医学院附属巴中医院肝胆胰脾血管外科,四川 巴中 636000
- 折叠
摘要
Abstract
Objective To explore whether cognition based on"pseudo-triangle"abnormal anatomy can effectively reduce the incidence of bile duct transection injury during laparoscopic cholecystectomy(LC).Methods Clinical data of patients who underwent LC at Bazhong Hospital Affiliated to North Sichuan Medical College were retrospectively analyzed.The study included two cohorts.Early cohort(October 2006 to October 2018):Among 1 107 patients,35 who suffered bile duct transection injury were assigned to the case group,while 140 patients without injuries during the same period were randomly selected as the control group.Based on data from the early cohort,to analyze the risk factors for bile duct transection injury,to summarize intraoperative findings,and to define"pseudo-triangle"abnormal anatomy.Late cohort(November 2018 to October 2024):A total of 1 498 patients underwent LC,the concept of"pseudo-triangle"abnormal anatomy at this stage had been well known and had been applied in clinical practice.To compare the incidence change of bile duct transection injury between two cohorts.Results Baseline characteristics(age,gender distribution,body mass index,and types of diagnosis)were comparable between the early cohort and late cohort(P>0.05).Statistical analysis indicated that the presence of the"pseudo-triangle"anomaly,anatomical variation,and failure to achieve the critical view of safety(CVS)were significant risk factors for bile duct transection injury(P<0.05).Following the clinical implementation of the'pseudo-triangle'concept,the incidence of bile duct transection injury was significantly decreased[3.16%(35/1 107)in the early cohort,0.67%(10/1 498)in the late cohort(P<0.01)].The primary cause of injury shifted from"pseudo-triangle"misjudgment(68.6%in the early cohort)to anatomical variation(50.0%in the late cohort).Conclusion Correct recognition of the"pseudo-triangle"anatomical anomaly is an effective strategy for preventing bile duct transection injury during LC.By identifying specific anatomical risks and standardizing surgical traction,this strategy serves as a vital complement to the CVS standard,thereby reducing the incidence of bile duct transection injury.关键词
"伪三角"/异常解剖/腹腔镜胆囊切除术/胆管横断损伤Key words
"pseudo-triangle"/anatomical abnormalities/laparoscopic cholecystectomy/bile duct transection injury分类
医药卫生引用本文复制引用
程祥云,冯志宏,李坚,王良波,魏恒明,曹钰,郭兵,李明月,刘宇,阿木金刚.."伪三角"异常解剖认知在腹腔镜胆囊切除术胆管横断损伤预防中的临床应用[J].肝胆胰外科杂志,2026,38(5):325-331,7.
