胆囊切除术致胆管损伤的预防与治疗

The prevention and treatment of bile duct injuries during cholecys tectomy：reportof 10 cases

目的 探讨胆囊切除术（LC及OC）胆管损伤的预防和处理。方法回顾我院近10年来胆囊切除术（LC及OC）致胆管损伤9例及外院转入1例的临床资料，分析损伤的部位、类型、发现时间、手术方法和治疗效果。结果本组10例中6例行修补术或拆除缝线并T管引流痊愈出院；2例行胆肠Roux-en-Y吻合，痊愈出院；1例行肝圆韧带移植修补及T管引流，术后出现胆漏，经充分引流痊愈出院；1例因肝功能衰竭死亡。结论预防损伤和术中及时发现损伤是关键，胆管损伤的处理要根据损伤发现的时间、部位、类型等选择不同的方法。

AIM To investigate the prevention and treatment of bile duct injuries in open and laparoscopic cholecystectomy （OC and LC）. METHOD Ten cases of bile duct injuries associated with OC（n = 7） and LC（n = 3） were retrospectively analyzed. RESULTS Six patients were cured with bile duct suture or T- tube drainage, 2 with Roux - en - Y, I with ligament teres hepatis restoration and T- tube drainage, and I died of liver function failure. CONCLUSION Prevention and immediate repair with appropriate approaches are the keys to the cure of bile duct injuries during cholecystectomy.