医源性胆管损伤的原因及处理

Cause and treatment of iatrogenic bile duct injury

目的:探讨医源性胆管损伤的原因及处理。方法:对32例医源性胆管损伤病例的临床资料进行回顾性分析。结果:本组32例,痊愈30例,治愈率93.75%,死亡2例,死亡率6.25%。4例因术后胆管狭窄再次手术,其中2例经3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,胆管成形空肠Roux-en-Y吻合术是胆道重建术的最佳选择。

Objective ：To investigate the causes,prevention and treatment of iatrogenic bile duct injury.Methods ：The clinical data of 32 patients with iatrogenic bile duct injury treated in our hospital were retrospectively analyzed.Results：Of the 32 patients,30 （93.75%） were cured and 2 died （6.25%）.4 received reoperation due to bile stricture and 2 of them even received the reoperation for 3 times.Conclusion：Cholecystectomy is the most common reason for the iatrogenic bile duct injury.Improvement in understanding and prevention of the injury is very impertant.Roux-en-Y cholangiojejunostomy is the choice of therapy.