肝外胆道再次手术原因分析:附152例报告

Analysis of the causes for reoperation of extrahepatic biliary tract: a report of 152 cases

目的分析肝外胆道再次手术的原因,以期提高再次手术的安全性,降低再次手术率。方法回顾性分析4年8个月期间收治的152例肝外胆道再次手术患者的临床资料,主要包括既往手术原因、方式及再次手术的原因、方式。结果全组肝外胆道再手术原因:胆道残余结石(36例),结石复发(80例),胆道感染(12例),胆道损伤(18例)及其他(6例)。再次手术以胆总管探查+胆肠吻合为主,无1例围手术期死亡。术后随访1个月至2年,残石率为4.6%。结论肝外胆道再次手术的原因多种多样,但主要是胆道残余或复发结石(76.4%);胆道损伤亦不容忽视。

Objective To investigate the causes of reoperations for patients with biliary diseases so as to decrease the reoperative rates.Methods The clinical data of 152 patients with repeated biliary tract operations from January 2007 to August 2010 were analysized retrosepectively to study the causes,initial operative methods,and causes and methods of reoperations.Results Residual（n=36） and recurrent（n=80） bile duct stones were the main causes of reoperations for patients with biliary tract diseases（116/152,76%）.Other reasons were infection of biliary tract and bile duct injuries.Conclusions The causes for reoperation of extrahepatic biliay tract are multifactorial;main causes of reoperations were residual and recurrent bile duct stones,however,bile duct injuries and refluxing cholangitis should also be given special attention.