创伤性肝外胆道损伤的诊断和治疗

Diagnosis and treatment of extraheptic biliary duct trauma

目的 探讨创伤性肝外胆道损伤的诊治方法。方法 回顾分析本组 17例创伤性肝外胆道损伤的诊治资料。结果 17例均于术中确诊。 10例胆囊破裂均行胆囊切除术 ;4例胆总管部分破裂行缝合修补术并“T”管引流 ;2例胆总管横断行胆总管空肠Roux en Y吻合术 ;1例胰腺段胆管断裂行胰十二指肠切除术。本组 17例均治愈。结论 创伤性肝外胆道损伤术前诊断困难 ,常于术中确诊。治疗可采用胆囊切除术 ,一期缝合修补术 ,胆肠吻合术和胰十二指肠切除术等手术治疗 ,包括单纯左。

Objective To investigate into the diagnosis and management of the extrahepatic biliary ductal trauma.?Methods Seventeen cases of extrahepatic biliary ductal trauma were studied restrospectively.?Results All the 17 patients were diagnosed during the operation. Ten patients with gallbladder disruption were managed with cholecystectomy,4 patients with partial laceration of the common bile duct were managed with suture repairs and adjuvant use of t tubes,2 patients with common bile duct disruption were managed with Roux en Y choledochojejunostomy,and 1 patient with avulsion of the common bile duct from the pancreas was managed with a pancreaticoduodenectomy. All the 17 patients recovered.?Conclusion The diagnosis of extrahepatic biliary ductal trauma is difficult before operation and the trauma is usually discovered in operation. Such trauma can be managed by cholecystectomy, bililary enteric anastomosis or pancreaticoduodenectomy. Single lobar bile duct injury can be managed by ligation.