胆道再次手术93例报告

The treatment of biliary reoperation

目的探讨胆道再次手术的原因、临床特点、术前评估及处理策略。方法回顾性分析东西湖区人民医院普通外科2009年5月至2014年11月收治的93例胆道再次手术病人的临床资料。结果胆道再次手术的主要原因为肝内外胆管结石的残留和复发,占83.9%(78/93);其次为反复发作的反流性胆管炎,占10.8%(10/93)。再次手术方式:根据病人具体情况选择T管引流、胆肠吻合及肝叶部分切除等。结论胆道再次手术难度大,应严格掌握手术指征、手术时机、手术方式,根据病人的具体情况,作出合理的选择,避免非计划性胆道再次手术。

Objective To investigate the causes, clinical features, preoperative assessment and treatment strategies of biliary tract reoperation. Methods From May 2009 to November 2014, the clinical data of 93 patients with biliary tract reoperation were retrospectively analyzed in Department of General Surgery of our hospital. Results The main causes of biliary tract reoperation were the residue and recurrence for the calculus of bile duct of liver inside and outside, accounting for 83. 9% （78/93）, followed by repeated attacks of reflux cholangitis. T tube drainage, biliary and intestinal anastomosis, lobe resection, etc. were chosen according to the conditions of the patients. Conclusions Biliary tract reoperation is difficult, and the surgical indications, operation opportunity, and surgical procedures should be strictly grasped. The treatment strategy is chosen individually to avoid unscheduled biliary tract reoperation.