医源性胆管损伤临床研究

Clinical Analysis of Iatrogenic Bile Duct Injury

目的研究医源性胆管损伤的原因、预防和处理方法。方法对1980年1月-2005年8月我院诊治的55例医源性胆管损伤的临床资料进行回顾性分析。结果对术中及术后不同时期发现的胆管损伤分别进行胆道修复、引流及胆肠吻合等方法处理,经1-25年随访,临床治愈率达96.4%(53/55)。结论胆囊切除术时Calot三角区解剖不清是发生医源性胆管损伤的主要原因。胆管损伤应早发现,及时处理。根据损伤的情况和术后时间选择不同的处理方法。

Objective To discuss the cause, prevention and treatment of iatrogenic bile duct injury. Methods 55 eases of iatrogenic bile duet injury at our hospital from January 1980 to August 2005 were analyzed retrospectively. Results All eases were underwent bile duet respiration, drainage or Roux - en - Y eholedoehojejunostomy respectively. 53 patients were with good result. The curative rate was 96.4% （53/55）. 2 patients died of biliary fistula and infectious shock. Conclusion Bile duet injuries often occurs after eholeeysteetomy of bile duet surgery. The anatomy of Calot triangle and topography of extrahepatie bile duet should be identified clearly, Bile duet injury should be discovered early and operated timely. Different treatment are optional according to the degree of injury and postoperative period.