肝门部胆管损伤外科处理30年回顾  

A review of thirty years' exprience in surgical management of injuries of bile duct at hepatic portal

作　　者：郑樟栋[1] 陈凯[1] 张家敏[1] 吴荣进[1] 曾天定[1] 

机构地区：[1]浙江省金华市中心医院外科,321000

出　　处：《中华肝胆外科杂志》1998年第2期82-83,共2页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的为了探讨肝门部胆管损伤的诊断和治疗。方法作者对1966年至1995年间2409例单纯胆囊切除术后发生的24例肝门部胆管损伤病例进行了回顾性分析。其中1例为肝总管误扎、仅作了误扎缝线拆除。其余23例肝门部胆管横断者作了不同方式的胆道修复。结果全组无围手术期死亡。随访20例中。3例有反复胆管炎的远期并发症。其中1例死于胆汁性肝硬化后的门静脉高压症、上消化道大出血。结论作者认为早期诊断和选择恰当的手术方式,能够改善肝门部胆管损伤的预后。Objective To study the diagnosis and surgical management for injuries of bile duct at hepatic portal.Methods Twenty-four patients with injuries of bile duct at hepatic portal after cholecys- tectomy occurred during the past three decades were reviewed.All patients with the duct transected were repaired in different ways,except one whose common hepatic duct was missutured without damage.Results There were no peri-operative deaths in the group.3 had repeated attack of cholangitis among 20 pa- tients followed-up.Of them,one died from massive hemorrhage of upper digestive tract caused by portal hypertension after biliary cirrhosis.Conclusion From the study,the authors consider that early diagnosis of and appropriate management for the injuries of bile duct at hepatic portal can improve the clinical results.

关 键 词：肝门部 胆管损伤 外科处理 胆汁性肝硬化 单纯胆囊切除术 肝总管 远期并发症 诊断和治疗 

分 类 号：R657[医药卫生—外科学] R735.8[医药卫生—临床医学]