胆管损伤的外科处理

Surgical management of bile duct injury

医源性胆管损伤以胆囊切除术所致最多。分析了胆管损伤的原因、分型、诊断,根据胆管损伤的时机不同,采取不同的处理策略及控制感染。详细阐述了胆管损伤确定性修复术的选择,特别是胆肠Roux-Y吻合术的手术要点。此外,在严格把握适应证的情况下,可以联合肝切除术,甚至是肝移植。

Cholecystectomy is the most common cause of iatrogenic bile duct injury.The causes,classification and diagnosis of bile duct injury were analyzed.According to the different opportunity of bile duct injury,different treatment strategies and infection control were adopted.The selection of definitive repair of bile duct injury,especially the key points of Roux-Y cholangiojejunostomy,was described in detail.In addition,under the condition of strict indication,it can be combined with hepatectomy or even liver transplantation.