重视医源性胆道损伤的解剖性危险因素

Thinking highly of the anatomic Risk factors of IBDI

医源性胆道损伤是临床上胆道手术,特别是胆囊切除术常见的并发症之一。随着LC和小切口胆囊切除术等新型术式的广泛开展,其发生率不断增加。医源性胆道损伤的增加是多种因素综合作用的结果,解剖变异是其中的常见原因之一,“肝十二指肠区”存在着较大的个体差异,且病理性原因所致的解剖变异纷繁复杂,熟悉胆道各种解剖变异,这是手术成功避免胆道损伤的基础。术者必须以全新的视角对待每一例手术,时刻想到各种变异情况,尽己所能处理好。

Iatrogenic bile duct injury（IBDI） is one of the complications in the operation on biliary tract,especially on cholecystectomy. With the greatly development of the new type technique on laparoscopic cholecystectomy（LC） and cholecystectomy with small incision,the incidence is increasing constantly.The accrescence of the IBDI is a consequence by many synthetic action. Anatomic variation is one of the common factors, the section of liver and dodecadactylon exist greatly individual variation,and exist variations by some pathological factors.knowing well all kinds of anatomic variations in biliary tract is a foundation of the operations which successfully avoided iatrogenic injure of the biliary.Operators must treat per case with new view angles, think of all kinds of anatomic variations at a moment,and that sovle it as well as possiblly.