胆管手术中十二指肠损伤的临床分析

The clinical analysis of duodenal injury in billiary operation

目的探讨胆管手术中十二指肠损伤的原因及防治方法。方法回顾性分析我院1990～2008年诊治的15例胆管手术中十二指肠损伤患者的临床资料。结果手术者的操作技巧和手术经验不足是引起胆管手术中十二指肠损伤的主要原因,本组患者术中发现7例,术后发现8例。所有患者均治愈,无1例死亡。结论胆管手术中十二指肠损伤最重要在于预防,而术者操作技巧和手术经验的提高以及胆管镜的常规使用是预防的关键。术中十二指肠损伤的及时发现,建立充分有效的十二指肠腔内外引流,积极的抗感染和全身营养支持是治疗的关键。

Objective To explore the reasons, prevention and treatment of duodenal injury in biliary operations. Methods The clinical data of 15 patients with duodenal injuries in biliary operation who were treated in our hospital from 1990 to 2008 were analyzed retrospectively. Results The lack of experience and improper skills of the operator is the main reason causing duodenal injury.7 patients were found duodenal injury during the operation, and 8 patients were found after the operation. All patients were cured without any mortality. Conclusion The prevention is the most important thing to avoid the duodenal injury. The improvement of the experience and the skill and the routine use of choledocoscopy is the key of prevention. To detect the injury and enough drainag in intro-or extra- duodenum during the operation and anti-infection and nutrition support after the operation are the key of treatment.