医源性胆管损伤并狭窄（附18例分析）

IATROGENIC INJURIES OF THE BILIARY DUCTS

本文报告１８例医源性胆管损伤，１４例发生于胆囊切除，４例发生于胃大部切除。４例经总胆管十二指肠吻合，７例经胆管修补Ｔ管支撑，２例胆管端端吻合Ｔ管支撑，５例经肝总管空肠Ｒｏｕｘ一ｅｎ一Ｙ吻合，１７例治愈，１例死于心脏病。作者认为Ｒｏｕｘ一ｅｎ一Ｙ吻合术疗效最可靠。

8 cases of iatrogenic bile duct injury were reported. 14 occurred duringcholecystectomy and 4 during subtotal gastrectomy. Duct repair with T tubeprosthesis was performed in 7 cases ,hepatic duct-duodenal anastomosis was in4 cases ,bile duct end to end anastomosis with T tube prosthesis was in 2 cases.Roux-en-Y anastomosis of the bile duct and jejunum was in 5. 17 patients recov-ered while one died of cardiac attack. The authors feel that the Roux-en-Y pre-cedure was more reliable as there was no stenosis occurred in this group at followup .