医源性胆管损伤的预防和处理(附74例报告)

<title>evention and treatment of iatrogenic bile duct injury: a report of 74 cases .

目的 探讨医源性胆管损伤的原因、预防及处理。方法 对74例医源性胆管损伤的临床资料进行回顾性分析。结果 本组74例,痊愈69例,治愈率93.2%,死亡5例,死亡率6.8%。随访58例,随访率78.4%,平均随访4.2年。8例因术后胆管狭窄再次手术,其中3例经4次手术治疗。结论 胆囊切除术是医源性胆管损伤的主要原因,提高认识、预防损伤是关键,把握首次治疗时机和选择合理方法极为重要。

<abstract>jective To investigate the causes, prevention and treatment of iatrogenic bile duct injury. Methods The clinical data of 74 patients with iatrogenic bile duct injury treated in our hospital were retrospectively analyzed. Results Of the 74 patients, 69 (93.2%) were cured and 5 died (6. 8%). Fifty-eight patients (78. 4%) were followed up for an average of 4. 2 years. Eight received reoperation due to bile stricture and 3 of them even received the reoperation for 4 times. Conclusions Cholecystectomy is the most common reason for the iatrogenic bile duct injury. Improvement in understanding and prevention of the injury is very important. Meanwhile, grasping the chance of the first operation and choosing reasonable approach is crucial.