多次胆道术后再手术的粘连分解技巧

Dividing technique of adhesion after biliary multi-surgery

目的探讨胆道再次和多次胆道手术粘连松解技巧。方法回顾性分析该院2002年3月～2009年4月7年间的再次和多次胆道手术78例,按松解粘连方法分成2组,采用随机法操作32例,松解粘连采用"十八字"方法操作46例。结果随机法操作32例,术中发生胃穿孔损伤2例,十二指肠损伤1例,空肠穿孔损伤1例,门静损伤1例,术中损伤邻近脏器发生率占15.6%。"十八字"方法操作46例,无术中脏器损伤。结论 "十八字"粘连分解法在再次和多次胆道术中能够有效防止术中脏器损伤,具有临床推广价值。

【Objectives】To explore the dividing technique of adhesion after biliary multi-surgery.【Methods】 78 cases with operation again after two or more times of biliary surgery were analyzed retrospectively from March 2002 to April 2009.The cases were divided into two groups according to the dividing technique of adhesion,including 32 cases with random dividing method and 46 cases with a ＂18 words＂ method.【Results】 There were 2 cases with gastric perforation,1 case with duodenal injury,1 case with jejunal perforation and 1 case with portal vein injury in random dividing group.There was no intraoperative injury in ＂18 words＂ method group.【Conclusion】＂18 words＂ method on dividing adhesion plays an important pole in preventing organ of biliary multi-surgery and it is worth applying in biliary operation.