胆道损伤一期修复后胆管狭窄的预防  

INVESTIGATION ON THE PREVENTIONAL MANAGMENT FOR THE BILIARY STRICTURE AFTER ONE-STAGE REPAIRMENT

作　　者：玉苏甫.依米提 李海涛[1] 张新峰[1] 排祖拉[1] 李涛[1] 吐尔洪江.吐逊 温浩[1] 

机构地区：[1]新疆医科大学第一附属医院,乌鲁木齐830054

出　　处：《肝胆外科杂志》2010年第3期199-201,共3页Journal of Hepatobiliary Surgery

摘　　要：目的探讨胆道损伤一期修复后胆道狭窄的预防措施。方法回顾分析58例胆道损伤一期修补病例,根据术中是否放置胆道支撑管分为2组,A组12例,一期修复并经胆囊管向胆总管内置管减压引流;B组46例,一期修复术并常规行修补段胆道"T"型管支撑。两组术后随访,观察治疗效果。结果 A组12例患者现随访时间1～4年,尚无任何胆道并发症出现,而1例患者随访2年尚未见有任何胆道并发症后失访,所有病例均行肝功能检测及胆道B超检查未见明显异常。B组随访42例(93.33%),因出现胆道狭窄再次手术者29例,占63.04%(29/46)。结论胆道损伤一期修复后不放置支撑管而单纯由残留胆囊管放置胆道减压引流是安全可行的,可减少术后胆道梗阻的并发症。Objective To investigate the preventional methods of the biliary striture after one-stage repairment.Methods 58 cases from 1996～2007 were enrroled in this retrospective study.All cases were performed biliary one-stage repairment and devided into two groups.Group A（n=12）were received bileduct drainage;Group B received T tube drainge.Results In group A,11 cases had benn followed for 1～4 years with no abnormality in liver function test、ultrasonography and no biliary related complications.1case was out of follow up after 2years.In group B,42 cases（42/46,93.33%）were follpwed for 1～4 years and 29 cases（63.04%,29/46）developed biliary stricture.Discussion biliary drainge via cystic duct inpatients those received one-stage repairment of biliary duct after injury showed feasible、safe and reduce the complications of biliary obstruction.

关 键 词：胆道损伤 一期修复 单管狭窄 预防 支撑管 

分 类 号：R657.4[医药卫生—外科学]