胆道再次手术73例分析

The analysis of 73 patients with bile duct reoperation

目的分析胆道再手术原因,总结诊治经验及教训。方法对1998年5月至2009年8月收治的73例胆道再次手术的临床资料进行回顾性分析。结果胆道再次手术的主要原因是肝胆管结石残留或复发,占全组病例的79.4%,其次为胆管狭窄、医源性损伤、肿瘤,再手术的方式以胆总管切开取石、肝叶段切除、胆肠吻合为主。结论胆道再次手术既有胆道疾病本身因素,亦有医源性因素;充分的术前准备及术前评估,结合内镜或术中超声或造影等,以"取净结石、解除狭窄、通畅引流、去除病灶、防治复发"为原则,选择合理手术方式是减少胆道再次手术的关键。

Objective To analysis the Characteristics cause of bile duct reoperation. andSumming up experiences and lessons. Methods Retrospective analysis of clinical data Right from May 1998 to August 2009 were treated 73 cases of biliary tract reoperation. Results Bile duct re-operation is mainly due to residual or recurrent bile duct stones,which occurred in 79. 4% of the reviewed cases. The secondary causes were bile duct stricture,iatrogenic injury,tumor. Re-operation approach to the common bile duct stones,hepatic resection,biliary-enteric. Conclusion Biliary tract reoperation of biliary tract disease itself both factors as well as iatro-genic factors; adequate preoperative preparation and pre-operative assessment,combined with endoscopic,or intraoperative ultrasound or angiography,in order to ＂ take the net stones,lifted narrow,smooth drainage,removal of lesions,prevent recurrence＂ the principle of rational choice is to key to reduce the biliary tract surgical re-operation.