摘要
目的通过医源性胆管损伤和狭窄病例的分析,探索最佳治疗方法。方法全组37例进行手术治疗。包括 Roux-Y 型空肠袢的浆膜修复胆管缺损,胆管端端吻合术,肝管空肠吻合术等。术后进行随访。结果术中发现胆管损伤11例,即行修复或重建,术后优良率91.0%;术后早期发现胆管损伤15例,术后长期优良率66.7%;晚期狭窄11例,术后长期优良率82.0%。结论术中发现胆管损伤,立即进行胆管修复或重建,可获得长期优良的效果;胆管重建时高位肝管空肠吻合术是值得选择的术式。
AIMS Thirty-seven patients bile duct injuries during operation and stric- tures were studied to find the best therapeutic method. METHODS All patients were operated on including:reparation of serosal with Roux-Y jejunal loop,biliobiliary anastomosis and hepaticojejunostomy.The follow up study was performed postoperatively. RESULTS Patients recognized during operation and bile duct repaired or reconstructed immediately had 91% good long-term results.The pa- tients of early postoperative recognition had 66.7% good long-term results.The patients of late bile duct stricutures had 82% good long-term results. CONCLUSIONS Immediate reparation or reconstruction of bile duct injury achieve good result.For most patients with late strictures,high hepati- cojejunostomy is the operation of choice.
