胆道再次手术76例分析

Clinical Analysis on 76 Patients Underwent Bile Duct Reoperation

目的：探讨胆道再次手术的术前评估及处理策略。方法：回顾性分析我院2005年7月~2010年4月收治的76例胆道再次手术病人的资料。既往有糖尿病史16例,高血压病史11例,肝功能不全19例,肺气肿3例,肾功能不全、甲亢和呼吸衰竭各1例。结果：再次手术时间1.5~7 h,平均为3.5 h,术中输血8例,输血量400~1200 ml,平均（545±389）ml,住院5~38 d,平均为（13±7.46）d,手术病人均无围手术期死亡,未发生严重的并发症。结论：通过对初次手术资料认真分析,严格掌握手术适应证,充分做好术前准备和评估,强调再次手术的处理原则,力争此次手术为最后1次胆道手术。

Objective：To investigate the preoperative evaluation and management strategy of bile duct reoperation.Method：Retrospective analysis of clinical data of 76 cases underwent bile duct reoperation in our hospital from July 2005 to April 2010.41 patients were male and 35 patients were female.The age of the patients ranged from 25 to 86 years old.16 cases had a history of diabetes,11 cases had a history of hypertension,19 cases had hepatic insufficiency,3 cases had pulmonary emphysema,and 1 case had renal insufficiency,hyperthyroidism and respiratory failure,respectively.Results：The operation time was from 1.5 hours to 7 hours,and the mean time was 3.5 hours.8 cases had blood transfusion during the operation,and blood transfusion ranged from 400ml to 1200ml,and the mean blood volume was（545±389ml）.The length of stay in hospital was from 5 days to 38 days,and the average hospital day was 13±7.46 days.There were no death during perioperative period and serious complications.Conclusion：Bile duct reoperation is safe and feasible through analysising the initial surgery information carefully,controlling the surgical indications strictly and emphasizing the processing principle of reoperation with sufficient preparation and evaluation of preoperation.