医源性肝外胆管横断伤的一期修复的手术适应症

Surgical Indications Operative Techniques and Related Complications of Primary Repair of Iatrogenic Extrahepatic Bile Duct Transection

目的探讨医源性外胆管横断伤的一期修复的手术适应症、手术技巧及相关并发症情况。方法取材于近五年来我院就诊的医源性肝外胆管横断伤患者,数量为23例,回顾分析选中患者的临床资料,选中患者的治疗方法均为开腹手术方法,对其中20例患者使用一期修复术进行治疗。结果从外院转入我院进行治疗的一例患者,经过与其家属进行协商后,使用一期胆管对端吻合修复术对其进行治疗,手术效果明显,术后痊愈出院。20例接受一期胆管对端吻合修复术的患者,9例患者在治疗中出现并发症,在针对性处理后均痊愈。患者均痊愈出院后,经过两年内的随访调查,发现患者均未出现胆道狭窄和胆道梗阻的现象,治疗效果显著。结论合理使用一期修复术对胆管离断伤患者进行治疗,能够取得不错的治疗效果,但是要保证精准的胆道吻合技术方法,以保证能够成功完成修复手术。

Objective To investigate the surgical indications,surgical techniques and complications of primary repair of iatrogenic transection of the external bile duct.Methods Based on the recent five years in our hospital for treatment of iatrogenic bile duct injury patients,the number of 23 cases,retrospective analysis of selected patients with clinical data,select treatment methods for patients with both methods of open surgery,including 20 cases of patients with primary repair surgery treatment.Results From the external hospital into our hospital for treatment of patients,and after consultation with their families,the use of a bile duct to end anastomosis repair surgery for its treatment,the operation effect is obvious,postoperative recovery and discharge.In 20 patients who received onestage biliary anastomosis repair,9 patients developed complications during the treatment and were cured after targeted treatment.After the patients were all cured,the patients were followed up for two years and found no biliary stricture and obstruction of bile duct.The treatment effect was remarkable.Conclusion The rational use of one stage repair for the treatment of bile duct transection injury patients can obtain good therapeutic effect,but to ensure the accurate biliary anastomosis technique,in order to ensure the successful completion of surgery to repair.