T管拔除时发生胆漏的原因分析及防治

Causes, prevention and treatment of biliary leakage after removel of T-tubes from the common bile duct.

目的探讨拔除T管发生胆漏的原因及防治方法。方法对2001年～2006年行胆道探查T管引流术后,T管拔除时发生胆漏病人25例临床资料进行分析总结。结果经窦道置入尿管引流保守治疗痊愈4人,再次胆道探查T管引流治疗痊愈21人,无死亡病例。结论胆漏发生与病人体质、术中置管及拔管技巧等各种因素有关,预防胆漏应从术中做起,拔管时间应遵循个体化原则,拔管操作应规范、轻柔,胆漏发生后应视具体情况采取保守治疗或急诊手术治疗。

Objective To investigate the cause, prevention and treatment of biliary leakage after removel of T-tubes from the common bile duct. Methods The clinical data of 25 patients with biliary leakage after removel of T-tubes from the common bile duct at our hospital from 2001 to 2006 were reviewed. Results 4 patients were cured with nonoperation and 21 cases were cured by reoperation of biliary duct. Conclusion Biliary leakage relates to the patients＇ physique,T-tubes laying and removal method.Prevention of biliary leakage should begin at operation.Removal of T-tubes must be standard and gentle.Conservative or reoperative therapy would be taken according to the conditions of biliary leakage.