46例医源性胆道损伤的临床分析

Analysis of Dignosis and Treatment of 46 cases with Iatrogenic Biling Duct mjury

目的总结分析15年我院收治的46例医源性胆管损伤的有关资料。方法进行回顾性分析,其中发生于LC39例,胆总管探查术7例。21例行胆管修复或对端吻合加T管引流术,25例行胆管空肠Roux-en-Y吻合术。结果2例死亡,3例反复胆管炎远期并发症,41例痊愈。结论作者认为术中发现胆管损伤即行对端吻合或修复加T管引流;术中吻合困难,术后数天发现或重建术失败者,最宜行规范的胆肠Roux-en-Y吻合术,疗效满意。

Objective Forty-six patients with iatrogenie injuries of bile duct were treated during 15 years in our hospital. Methods Among them, 39eases occurred during LC, and 7 during exploration of the common bile duet. 21 cases were repaired by bile duet end-to-end anastomosis or with T tube prosthesis, and 25 eases by Roux-en-Y type hepatic eholangiojejunostomy. Results 2 patients died, 3 had repeated attack of eholangitis, the rest patients recovered completely. Result The authors think that to manage patient immeadiately by end-to-end anastomosis of the bile duct or repaire with T tube prosthesis during surgery is reliable. For patients whose anatomosis is very hard in the operation and whose treatment is delayed for several days or reconstruction surgery is failed, the Roux-en-Y procedure is more rialialible.