医源性肝外胆管损伤12例诊治分析

Clinical analysis of iatrogenic bile duct injury in 12 cases

目的:探讨医源性胆管损伤的原因及对策。方法:总结分析行胆囊切除术致肝外胆管损伤12例病例资料。结果:无死亡病例,治愈11例,1例术后早期反复发生胆道感染,于术后6个月经ERCP行狭窄的吻合口扩张并植入支架,术后恢复良好。结论:提高肝胆外科医师对本病的认识水平,对行腹腔镜胆囊切除时的可疑胆管损伤患者应积极主动开腹探查,对已损伤病例选择正确处置方法,降低死亡率,提高本病的治愈率。

Objective To investigate and analyze the cause and treatment of iatrogenic bile duct injury. Method The 12 cases due to bile duct injury at surgery were ,treated in our hospital were reviewed retrospectively from Jan 1995 to Dec 2011. Results This group of pa- tients had no deaths. I1 patients were cured. One ease of postoperative had recurrent billary infection. After six months ,narrow anastomotie was dilated by ERCP and a stent was implanted. Conclusion To improve the understanding of iatrogenic bile duct injury is very important to prevent intraoperative injury of bile duet. Suspected bile duct injury patients should be performed an explorative laparotomy. Confirmed al- ready bile duet injury patients should be received the right treatment.