医源性肝外胆管损伤的原因及处理(附182例综合报道)  

Iatrogenic extrahepatic bile duct injury and treatment(a report of 182 cases).

作　　者：戴显伟[1,2,3,4] 陈亚进[1,2,3,4] 高志清 石景森[1,2,3,4] 杨福全 马凯[1,2,3,4] 邱芳[1,2,3,4] 赵海鹰 卜宪民[1,2,3,4] 戴阳 王亮[1,2,3,4] 张磊 陈积圣[1,2,3,4] 赵青川 孙凯[1,2,3,4] 杨毅军 王林[1,2,3,4] 焦兴元 卢云[1,2,3,4] 赵风林 

机构地区：[1]中国医科大学第二临床学院肝胆外科 [2]中山医科大学孙逸仙纪念医院肝胆外科 [3]第四军医大学西京医院肝胆外科 [4]西安医科大学第一附属医院肝胆外科研究室

出　　处：《中国实用外科杂志》1999年第8期485-487,共3页Chinese Journal of Practical Surgery

摘　　要：目的探讨医源性胆管损伤的原因及处理方法。方法综合国内４家医院收治的１８２例医源性肝外胆管损伤的临床资料，进行回顾性分析。结果１７２例经行胆管对端吻合或胆肠Ｒｏｕｘ－ｅｎ－Ｙ吻合术后恢复良好，病死率５５％（１０／１８２）。结论胆囊切除术时应认清胆囊三角解剖关系，单纯胆囊切除时，应行逆行胆囊切除术。胆管损伤应尽早发现，及时处理。根据损伤的情况和术后时间选择不同的处理方法。Objective To discuss the causes and treatments for iatrogenic bile duct injury.Methods 182 cases of iatrogenic bile duct injury were reviewed and analyzed,these patients from 4 university hospitals of China.Results All patients were underwent choledochocholedochostomy or Roux-en-Y operation.172 patients were with good result,mortality was 5 5%(10/182).Conclusion During cholecystectomy the anatomy of Calot's triangle should be identified clearly.Retrograde cholecystectomy is the rational choice.Bile duct injury should be discovered as soon as possible and be operated in time.Different treatments are optional according to the degree of injury and postoperative period.

关 键 词：医源性 胆管损伤 胆肠吻合术 胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]