探讨腹腔镜胆囊切除术（LC）中出现胆管损伤后的处理方法。

回顾性分析开滦总医院2003年3月至2017年3月LC术中出现胆管损伤的18例临床资料，包括针孔样胆管损伤5例，损伤小于胆管直径1/2者5例，损伤超过胆总管直径1/2者3例，胆管完全横断损伤、无组织损伤3例，胆总管完全横断、左肝管横断、右肝管部分横断损伤1例，胆总管横断损伤1例，伴组织缺损超过2 cm损伤1例。

18例胆管损伤中仅1例Ⅵ型行胆肠Roux-Y吻合；Ⅰ-Ⅴ型通过简单修补或断端吻合，T管支撑、充分引流，维持了正常的胆管生理结构，术后中位随访时间2.93年，无严重并发症及死亡，获得痊愈。

LC中及时发现胆管损伤、恰当的手术方式选择及维持胆道通畅是预后良好的关键。

To explore the treatment methods of biliary tract injury in laparoscopic cholecystectomy (LC).

A retrospective analysis of eighteen cases with bile duct injury during LC from March 2003 to March 2017 in Kailuan General Hospital was conducted. There were 5 cases of needle like bile duct injury, 5 of injury less than 1/2 diameter of bile duct, 3 of injury more than 1/2 of common bile duct, complete transverse injury of bile duct, 3 of no tissue injury, 1 of total bile duct transection, left hepatic duct transection, right hepatic duct partial transverse injury, 1 of common bile duct injury, and 1 of tissue defect exceeding 2 cm.

Of the 18 cases of bile duct injury, only one case with type Ⅵwas anastomosed with Roux-Y. Patients with type Ⅰ-Ⅴ were treated by simple repair or end-to-end anastomosis, T-tube support and adequate drainage to maintain normal biliary physiology. Through a median follow-up of 2.93 years, no serious complications or death were recovered.

Detection of bile duct injury, proper surgical approach and maintenance of biliary patency is key to good prognosis during LC.