医源性胆道损伤的早期发现和一期修复手术治疗

Early diagnosis and the one-stage prosthesis operation for iatrogenic blie duct injury

目的探讨医源性胆道损伤的早期诊断和诊治经验。方法对2000～2012年间治疗的27例胆道损伤进行回顾性分析。结果 27例胆道损伤术中及术后早期发现并行一期修复整形、T管支撑引流22例,1例术后T管脱落后胆管狭窄再次手术,其余21例治疗效果好,另5例二次手术行胆肠Roux-en-Y吻合,1例吻合口狭窄再次手术后痊愈。结论胆管损伤应尽早发现,并选以合适的治疗方法早期处理,比后期处理效果好。一期手术以修复整形为首选。

Objectives The article inquire into iatrogenic bile duct injury of early stage diagnosis and treatment. Methods We review and analyse 27 cases with bile duct injury who have treated from 2000 to 2012. Results 21 cases underwent plastic operation and obtained good results. 1 case experienced re-operation due to the defluvium of the stent tube Five cases were operated for cholongiojejunostomy twice, two cases went through operation once again due to the stricture of the anastomotic stoma. Conclusion Bile duct injury is found earlier,The surgeon must choose to deal with it. It can reach good results that the laterstage of operation deal with it. First method is to operative repair and palstic operation.