胆囊切除术致胆管损伤的外科治疗

THE SURGICAL TREATMENT OF BILE DUCT INJURY FOLLOWING CHOLECYSTECTOMY

本文报道因胆囊切除所致胆管损伤共26例,20例为选择性胆囊切除术,6例系急诊手术,术中即时作出胆管损伤的诊断14例(53.8％),其余12例(46.2％)未作出诊断.文中对胆管损伤的原因和胆管重建进行了讨论,认为通常胆管损伤的原因是由于手术匆忙和粗心,特别易于发生在“容易”切除的胆囊;预防是非常重要的,并认为几乎所有手术损伤胆管都是可以避免的.

This paper reports of twenty six patients with bile ducts injury following cholecys-tectomy, twenty cases were selective cholecystectomy and six were emergency. The diagnosis of bile ducts injury is made during the initial operation in 14 cases (53. 8%), and the rest(46. 2%) is not. The cause of injuries of bile ducts and reconstruction are discussed. In the paper, we belive that these injuries are generally caused by hurry and carelessness specially for 'easy' cholecystec-tomy. It is very important to prevent the bile duct injury and almost all operative injuries of bile ducts can be avoided.