医源性胆管损伤43例诊治体会  

Experienc in diagnosis and treatment of iatrogenic bile duct injury： Report of 43 eases

作　　者：孔雕雕[1] 毛晓雯[1] 熊良昆[1] 李昌盛[1] 潘定宇[1] 刘志苏[1] 

机构地区：[1]武汉大学中南医院普外科,430071

出　　处：《腹部外科》2012年第5期281-282,共2页Journal of Abdominal Surgery

摘　　要：目的探讨医源性胆管损伤的诊治方法。方法回顾性分析收治的43例胆管损伤的临床资料。结果诊断依赖于临床症状、体征和影像学检查，其中磁共振胰胆管成像（MRCP）确诊率可达97．2％。43例均行手术治疗，38例行胆肠吻合术，除1例死亡外，余均治愈出院。结论胆管损伤主要发生在胆囊切除术中，黄疸是损伤后最常见的症状，MRCP是胆管损伤定位诊断的首选影像学检查，Roux-en-Y胆管空肠吻合术是最常用、疗效最为肯定的重建手术。胆管损伤重点在于预防。Objective To explore the diagnosis and treatment of iatrogenic bile duct injury （IBDI）. Methods The clinical data of 43 cases of IBDI admitted were analyzed retrospectively. Results IBDI was clinically diagnosed in terms of the clinical findings and imaging examination. Magnetic resonance cholangiopancreatography （MRCP） was the most sensitive diagnostic means （97. 2 ~ ）. All the patients were subjected to the surgical treatment, including 38 cases receiving hepato-duodenal Roux-en-Y anastomo- sis. All cases were cured except one death. Conclusion Most injuries occurred during open cholecystectomy. Jaundice was the most frequent sign upon admission. MRCP is the preferred imaging examination of localiza- tion of bile duct injury. Hepato-duodenal Roux-en-Y anastomosis was the most often employed surgical technique. Biliary injuries are more easy to prevent than to treat.

关 键 词：胆囊切除术 胆道 手术中并发症 诊断 治疗 

分 类 号：R657.4[医药卫生—外科学]