手术修复医源性胆道损伤的远期疗效探讨  

作　　者：邓和军[1] 刘家隽[1] 黄映明[1] 冉崇新[1] 殷子奇[1] 

机构地区：[1]重庆市肿瘤研究所肝胆科,400030

出　　处：《当代医学》2009年第16期80-80,43,共2页Contemporary Medicine

摘　　要：目的探讨手术修复医源性胆道损伤的远期疗效。方法回顾分析1990年1月～2006年12月我科开腹胆囊切除术1654例与腹腔镜胆囊切除术587例的临床资料,发生胆道损伤9例,其中开腹手术所致胆道损伤3例,腹腔镜手术所致胆道损伤6例。行胆总管-空场Roux-en-Y吻合术2例,胆管端-端吻合+T管引流术3例,胆管壁修补术4例。结果9例胆道损伤经过不同手术方式修复后均治愈出院,随访2～15年,无胆道狭窄、胆道感染及胆管结石等并发症。结论不同手术方式修复医源性胆道损伤的远期疗效良好,及时发现胆道损伤,采用合适的手术方式修复是保证手术成功和良好疗效的关键。Ojective To study the long curative effect ofiatrogenic bile duct injure by operation. Methods From Jan.1990 to Dee. 2006,9 cases had bile duct injure in 1654 cases with open cholecystectomy and 587 cases with laparoseopic cholecystectomy, 3 cases were caused by open cholecystectomy, and 6 cases were caused by laparoscopic cholecystecto-my.Two cases with bile duct injure underwent Roux-en-Y anastomosis, three of them underwent end to end bile duct anastomosis plus T tube insertion,the orther four underwent bile duct wall repair, the clinical data were reviewed and studied.Results 9 cases with bile duct injure were cured with different operative methods ,all of them were followed up for 2 to 15 years after operation,no one had biliary strictures, bile duct infect -tion, choledocholith and other complication.Conclutions The long cura -tive effect of iatrogenic bile duct injury with different operative repair was very good, quick diagnosis of bile duct injury and repair with approp-riate operative methods were the key factors ensuring the ope-ration successful and good effect.

关 键 词：胆道损伤 胆道手术 腹腔镜 临床治疗 疗效 

分 类 号：R657.4[医药卫生—外科学]