胆囊切除术医源性胆管损伤的临床分析

Climical analysis on iatrogenic biliary tract injury due to cholecystectomy

目的探讨医源性胆管损伤的原因及处理措施。方法回顾分析近年来我院胆囊切除术致胆管损伤8例的病例资料。分析损伤的部位、类型、发现时间、手术方法和治疗效果等。结果术中发现胆管损伤并及时采用胆道端端吻合、胆肠吻合并引流6例，术后3d内发现胆道损伤再次手术2例。结论医源性胆管损伤关键是预防，术中及时发现、及时处理并采取有效的措施可减少并发症的发生。

Objective To discuss the methods of prerention and treatment of iatrogenic biliary tract injary. Methods Eight cases of iatrogenic biliary tract injury due to cholecysteetomy in our hospital during the past 15 years were retrospectively analyzed, the damage spot, type, discovery time, surgery method and treatment result were analyzed. Results Six eases of biliary tract injury were found during the operation and were promptly treated by biliary tract end to end anastomosis, biliary intestinal anastomosis and biliary tract drainage ; another 2 cases of biliary tract injury were found in 3 days after the operation and received reoperation. Conclusion For iatrogenie biliary tract injury, the prevention is the key ; the prompt discvery, and adoptipn of the effective surgery method in the operation is very important.