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Clinical analysis of iatrogenic bile duct injury on 112 cases

Clinical analysis of iatrogenic bile duct injury on 112 cases
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摘要 To explore the cause of iatrogenic bile duct injury and find the effective methods for prevention and treatment of the injury.Methods Clinical data of 112 cases with iatrogenic bile duct injury in ten hospitals located in Songhua river drainage area from January 1978 to January 2003 are analyzed here retrospectively.Results The main cause of iatrogenic bile duct injury was wrong identifying the anatomy of the Calot’s triangle before cholecystectomy ,accounting for 55.4%(62/112). Diagnosis depended on clinical features, celiac puncture and imaging examination. Ultrasonography was among the most sensitive diagnostic means (diagnostic rate=97.5%).Six types of injury identified according to their locations and type Ⅲ of damages was most common in clinical practice (92/112). The curative rate in this group was 95.5%(107/112). Eighty-seven cases (77.7%) underwent Roux-en-Y choledochojejunostomy, with the cure rate of 94.3%(82/87).Conclusion Iatrogenic bile duct injury prevention lies in identifing the topography of extrahepatic bile ducts. Roux-en-Y choledochojejunostomy is usually the choice of therapy. To explore the cause of iatrogenic bile duct injury and find the effective methods for prevention and treatment of the injury.Methods Clinical data of 112 cases with iatrogenic bile duct injury in ten hospitals located in Songhua river drainage area from January 1978 to January 2003 are analyzed here retrospectively.Results The main cause of iatrogenic bile duct injury was wrong identifying the anatomy of the Calot's triangle before cholecystectomy ,accounting for 55.4%(62/112). Diagnosis depended on clinical features, celiac puncture and imaging examination. Ultrasonography was among the most sensitive diagnostic means (diagnostic rate=97.5%).Six types of injury identified according to their locations and type Ⅲ of damages was most common in clinical practice (92/112). The curative rate in this group was 95.5%(107/112). Eighty-seven cases (77.7%) underwent Roux-en-Y choledochojejunostomy, with the cure rate of 94.3%(82/87).Conclusion Iatrogenic bile duct injury prevention lies in identifing the topography of extrahepatic bile ducts. Roux-en-Y choledochojejunostomy is usually the choice of therapy.
出处 《外科研究与新技术》 2005年第3期221-223,共3页 Surgical Research and New Technique
关键词 WOUNDS and INJURIES BILIARY TRACT diseases SURGICAL procedures OPERATIVE wounds and injuries biliary tract diseases surgical procedures operative
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