摘要
报告医源性胆管损伤３１例，其中２８例获随访，随访时间９月～６年。该病并非少见，其原因多种，主要为施术者的操作不正规和思想上重视不够，仅９例为术中发现。伤后的主要表现为进行性加深的黄疸和胆汁性腹膜炎。主要诊断方法为Ｂ超和ＥＲＣＰ检查。确诊后行胆管对端吻合效果最佳，胆管空肠Ｒｏｕｘ－Ｙ型吻合术亦为常用术式。本组４例行胆管对端吻合，效果良好；２３例行胆肠吻合，其中１７例良好，４例偶有腹痛，１例反复发生胆管炎，１例死亡。
31 cases of iatrogenic cholangic injury reported. 28 cases followed from 9 months to 6 years. Iatrogenic cholangic injury is not an uncommon occurence main cases are inregular procedures,and carelessness in this group,only 9 cases were found intraoperatively. The main manifestations after injury were aggravating jaundice and/or bilious peritonitis. Symptoms, signs, B-type ultrasound and sometimes ERCP were used for diagnosis. Once the injury ascertained, reoperation is under taken with precautionand precisions. Orthotopic rapair or direct union of severed ends are the best treatment, an alternative Roux-en-Y Cholangiojejunostomy was also commonly used. In this group, 4 cases received the first method and all with good results; 23 patients treated by the second method, 17 were uneventful, 4 experienced more or less abdomenal pain, 1 suffered difinite repeated cholangitis and another 1 died.
