医源性胆道损伤52例报告

Iatrogenic Biliary Duct Injury,Report of 52 Cases

目的:总结医源性胆道损伤的经验教训。方法:对过去33年间5 2例医源性胆道损伤进行回顾性分析。结果:肝外胆道手术所致4 8例,胃大部切除术及肝脏手术所致各2例。损伤部位在肝总管与胆总管交界处34例,肝总管6例,胆总管6例,左右肝管汇合部4例,左、右肝管各1例。胆管完全性损伤30例,部分性损伤2 2例。结论:要警惕医源性胆道损伤的发生。

Objective To summarize the experience and lesson drawn from iatrogenic biliary duct injury Methods Fifty-two patients with iatrogenic biliary duct injuries occurred in the past 33 years were studied retrospectively. Results Forty-eight cases were injured during the operation of extrahepatic bile duct,2 cases in partial gastrectomy and 2 cases in hepatectomy.The locations of injuries were at the junction of the common hepatic duct and common bile duct in 34 cases,at the common hepatic duct in 6,at the common bile in 34 cases,at the common hepatic ducts in 6,at the common bile duct in 6,at the junction of the left and right hepatic ducts in 4,and at the left and right hepatic duct in 1 case respectively.Complete biliary duct injuries were seen in 30 cases,partial injuries in 22 cases. Conclusion Carefulness is essential in performing operations on the liver,gallbladder,duodenum,pancreas and areas near the biliary system.Early detection of the injury and prompt repair are the keypoint of good results.