医源性胆管损伤  

Iaotrogenic bile duct injury

作　　者：李宜雄[1] 吕新生[1] 汤恢焕 刘恕[1] 刘冀宁[2] 

机构地区：[1]湖南医科大学附属湘雅医院普外科,湖南长沙410008 [2]湖南省人民医院肝胆外科,湖南长沙410002

出　　处：《中国普通外科杂志》2000年第2期139-142,共4页China Journal of General Surgery

摘　　要：目的　目的 :探讨医源性胆道损伤的预防和诊治方法。方法　对 91例医源性胆道损伤的临床资料进行回顾性分析。结果　 91例共施行手术 10 3次。其中 2次手术者 8例 ,3次手术者 2例。最后 1次手术方式为胆管端端吻合 18例 ,胆总管十二指肠吻合术 3例 ,胆管壁缺损修补 4例 ,单纯缝线拆除 1例 ,胆管空肠Roux en Y吻合 6 5例。 70例随访 1～ 10年 ,优良率 90 %。结论　胆囊切除术是医源性胆道损伤的主要原因 ,是可以避免的。肝管空肠Roux en Y吻合术是医源性胆道损伤或损伤性狭窄修复重建的首选方法。Objective To investigate the preventive measures and the diagnosis and treatment of iaotrogenic bile duct injury. Methods The clinical data of 91 cases of iatrogenic bile duct injury had been analysed retrospectively. Results 103 operations were performed on 91 patients. 8 of them underwent second operation. 2 underwent third operation. The last operation procedure as the following: end to end choledochocholedochostomy in 18 cases, choledochoduodenostomy in 3 cases, choledochojejunum Roux en Y anastomosis in 65 cases, repearing of duct defect in 4 cases, removing of suture simply in 1 case. 70 patients were followed up and 90% of them had a good result. Conclusions Cholecystectomy as a leading cause of iaotrogenic bile duct injury can be avoided. Hepaticojejunostomy is preferable procedure in the repairment and reconstruction of bile duct injury, especially in serious damage with traumatic stricutre.

关 键 词：胆管/损伤 医源性疾病 胆囊切除术/副作用 

分 类 号：R657.4[医药卫生—外科学]