胆囊切除术致胆管损伤的原因分析及处理

Clinical analysis of extrahepatic bile duct injury caused by cholecystectomy

目的探讨胆囊切除术致胆管损伤的原因以及处理措施和时机。方法回顾性分析我院外科收治的24例胆管损伤患者的病因以及采取的再手术方式和时间,预后情况。结果11例胆囊切除术中发现胆管损伤的患者,立刻行胆管修复等手术,预后情况满意;13例术后发现胆管损伤的患者,采取胆管手术处理,只有1例因胆汁性肝硬化,胆管感染死亡,其他患者未出现胆管狭窄和胆管炎等并发症。结论在胆囊切除术中,要注意可能发生胆管损伤的危险因素,加以避免,如存在胆管损伤,力争早发现,早治疗,可有效的减少胆管狭窄,胆管炎等并发症,提高患者的生存质量。

Objective To discuss the cause of the extrahepatic bile duct injury caused by cholecystectomy and its treatment. Methods A retrospective study was conducted on 24 cases of cxtrahepatic bile duct injury as to the causes, the means of reoperation, the timing and the prognosis. Results Eleven cases who developed extrahepatic bile duct injury during cholecystectomy underwent extrahepatic bile duct prosthesis, with satisfactory prognosis. Another 13 cases that were found to have injured extrahepatic bile duct after operation were treated with extrahepatic bile duct operation, among whom one died with bile duct infection caused by biliary cirrhosis. No complications occurred in the other cases. Conclusion In cholecystectomy, the danger of extrahepatic bile duct injury should be carefully observed and prevented. If indeed the case, early discovery and treatment will effectively reduce the occurrence of complications such as bile duct stenosis and cholangitis, thus improving patients＇living quality.