医源性胆管损伤的预防和处理

Prevention and trealment of iatrogenic bile duct injury

目的探讨医源性胆管损伤的原因、预防及处理。方法对13例医源性胆管损伤的临床资料进行回顾性分析。结果本组痊愈出院12例（92．3％），死亡1例（6．7％），术后随访8例，随访率61．5％，平均随访3年（1—5年）。其中1例手术1年后反复发作胆管炎，胆道造影证实胆管狭窄，再次手术后痊愈。结论胆囊切除术是医源性胆管损伤的主要原因，提高认识、预防损伤是关键，把握治疗时机和选择合理方法极为重要。

Objective To investigate the causes, prevention and treatment of iatrogenic bile duct injur. Methods The clinical data of 13 patients with iatrogenic bile duct injury treated in our hospital were retrospectively analyzed. Results Of the 13 patients,12 （92.3%）were cured and 1 died （6.7%） ,8 patients（61.5% ） were followed up for an average of 3 years. 1 patient received reoperation due to bile stricture. Conclusion Cholecystectomy is the most common reason for the iatrogenic bile duct injury. Improvement in understanding and prevention of the injury is very important. Meanwhile, grasping the chance of treatment and choosing easonable approach is crucial.