单纯胆囊切除致胆管损伤的防治体会

Prevention and treatment of bile duct injury during cholecystectomy

目的：探讨如何防治胆囊切除术中的胆管损伤。方法：对５６例因胆囊切除所致胆管损伤临床资料作回顾性分析。术中发现胆管损伤３２例，术后发现２４例。均施行修复手术。结果：治愈５４例，死亡２例。３７例术后随访０．５～１１年；其中远期效果良好者２４例，不佳者１３例。结论：合理选择胆囊切除术式，妥善处理胆囊动脉出血，有助于预防胆管损伤的发生。修复术式应根据胆管损伤情况合理选择。

Objective:To investigate methods of prevention and treatment of bile duct injury during cholecystectomy,through retrospective study of 56 cases.Methods:Among 56 patients(24 males and 32 females),bile duct injury were found in 32 during operation and 24 after operation.Prothesis was performed in all these patients.Results:54 cases were cured,and 2 died.37 patients were followed up from 0.5 to 11 years after operation.The data indicate that the ultimate result was good in 24 cases and not good in 13.Conclusions:The essential polits in prevention of bile duct injury are:to operate carefully,to select rational operation procedure and to manage approprately in ease of hemorrhage in artery.Method of prothesis should be selected according to the condition of bile duct injury,and stricture of the orifice should be prevented after anastomosis of the bile duct.