胆道术后大出血原因及防治

CAUSES AND TREATMENT OF POSTOPERATIVE MASSIVE HEMOBILIA (A REPROT OF 16 CASES).

目的 探讨胆道术后大出血的原因和治疗方法。方法 回顾性总结 1986年～ 2 0 0 0年收治胆道术后大出血 16例 ,其中非手术治疗 12例 ,再手术治疗 4例。结果 16例胆道术后大出血中 ,胆道结石合并感染 11例 (6 8.8% ) ;肝硬化门脉高压胆道术后 2例 (12 .5 % ) ;胆总管 -空肠 Roux- en- y吻合术后、肝外伤术后和胆道蛔虫症合并感染胆道出血各 1例 (18.7% )。治愈 14例 ;死亡 2例 ,分别于反复胆道出血、肝功衰竭 ;胆管癌晚期死亡。结论 胆道术后大出血 ,再手术治疗应慎重。非手术治疗无效者 。

Objective To investigate the causes and treatment of postoperative massive hemobilia.Methods From 1986 to 2000,16 patients with for postoperative massive hemobilia were reviewed.Among them,12 cases received conservative treatment and 4 cases underwent reoperative therapy.Results The causes of postiperative massive hemobilia included secondary infection from cholepathia-cholelithiasis in 11 cases (68.8%),portal hypertension cirrhotic in 2 cases,choledochojejunostomy (Roux-ey-y) and hepatic injury and ascariasis in 1 each respectively.in conservative and reoperative treatment,14 cases were cured and 2 cases died.Conclusion The postoperative massive hemobilia with reoperative therapy should be careful.Aggressive second surgicalapproach is recommended in patients who failed to conservative management.