肝胆外科手术后胆漏的原因及防治探讨

Bile leakage after hepatobiliary surgery and prevention of the causes

目的:对肝胆外科手术后胆漏的原因及防治进行探讨分析。方法:回顾2001年2月-2010年12月来我院进行肝胆手术发生胆漏的患者24例,年龄在19-71岁,平均年龄56岁,其中男16例,女8例,主要外科手术方式为开腹胆囊切除手术、胆总管切开取石,T管、腹腔引流,胆管癌切除术,胰十二指肠切除术,肝叶切除术,依据手术史、临床表现、腹腔穿刺及各种影像学检查诊断为胆漏,采取保守治疗。结果:24例肝胆手术后胆漏患者中,1例晚期胆管癌带管出院外,其余患者均在住院期间治愈,治愈率为95.83%,2周内治愈者15例(62.5%),3周治愈者8例(33.33%)。结论:胆漏重在预防,手术操作欠缺容易引起胆漏,外科手术医师要具有坚实的专业基础以及娴熟的手术技巧,对可能引起胆漏各种因素有充分的理解和认知,提高责任心和认真的态度,从根本上预防胆漏的发生。

Objective：Bile leakage after hepatobiliary surgery causes and prevention and control of analysis.Methods：February 2001-2010 came to our hospital on December Liver and Gallbladder surgery in patients with bile leakage occurred in 24 cases,aged 19-71 years,mean age 56 years,16 patients were male,female 8 patients,mainly abdominal surgical approach to cholecystectomy,common bile duct exploration,T tube,peritoneal drainage,bile duct resection,pancreatoduodenectomy,hepatectomy,according to surgical history,clinical manifestations,abdominal puncture and a variety of imaging diagnosis of bile leakage,treated conservatively.Results：24 patients with bile leakage after hepatobiliary surgery patients,1 patients with advanced bile duct cancer with pipe discharged,the remaining patients were cured in the hospital,the cure rate was 95.83%,2 weeks,15 patients were cured （62.5%）,3 weeks 8 cases were cured （33.33%）.Conclusion：Focus on prevention of bile leakage,the operation easily lead to lack of bile leakage,surgery,physicians should have a solid professional base and skilled surgical technique,bile leakage that may cause a variety of factors have sufficient understanding and awareness,improve accountability and serious attitude,and fundamentally prevent bile leakage.