胆囊胆管瘘5例报告  

BILIOBILIARY FISTULA:A REPORT ON FIVE CASES

作　　者：林守诚 范梅影 孟承伟 

机构地区：[1]上海第一医学院中山医院外科教研组

出　　处：《上海医学》1981年第6期20-21,69,共3页Shanghai Medical Journal

摘　　要：本文报告5例胆囊胆管瘘,其中3例为胆囊肝总管瘘,2例为胆囊胆总管瘘。对本病的诊断和治疗等问题进行了讨论.强调切忌盲目分离粘连,以免造成胆管损伤。Since 1977,3 cholecysto-common hepatic duct fistulae and 2 cholecystocholedochalfistulae were encountered during cholecystectomies.Stones were found either straddlingthe fistulous opening or passed through it and occluding the common bile duct.Theusual findings at operation were fusion between gallbladder and bile duct and thick-ening of the tissue near Calot’s triangle.In 2 cases,dissection of gallbladder led toinjury of common hepatic duct or hepatic duct.The defect in the common hepatic ductwas used to anastomose with duodenum while the lacerated hepatic duct was repaired,with T-tube drainage of common bile duct.In the other 2 cases,the fundus of thegallbladder was opened,gallbladder wall trimmed around the fistula and a T-tube in-serted via the fistulous opening.The tube was then oversewn with the gallbladderremnant around it and was removed 3 months later.In the remaining case,the fis-tulous opening was enlarged proximally and converted into a biliojejunostomy withthe gallbladder remnant forming the posterolateral wall of the anastomosis.All thepatients were well during follow-up 3-36 months postoperatively.

关 键 词：胆囊壁 嵌顿 吻合术 手术 胆管壁 结石 肝总管 胆囊胆管瘘 

分 类 号：R65[医药卫生—外科学]