胆道再手术的诊治体会  

Diagnosis and Treatment of Reoperations for Biliary Duct Disease

作　　者：钟伟[1] 倪谢根[1] 

机构地区：[1]安徽省淮南市第一人民医院普外科,232001

出　　处：《中华全科医学》2013年第9期1391-1392,1408,共3页Chinese Journal of General Practice

摘　　要：目的探讨胆道再次手术的原因、临床特点和处理。方法对2003年1月-2012年12月收治的46例胆道再次手术病例的临床资料进行回顾性分析。结果再次手术时间为2．1～6．0h，平均（4．5±2．2）h；术中输血6例，输血量为200～800ml，平均（500±100）ml；住院时间为12～38d，平均（21．04-5．0）d。羌围手术期死亡，未发生严重的并发症。结论再次胆道手术的主要原因是胆道结石。对于多次胆道术后需再次手术的病例，术前利用影像学对病情准确评估，制定合理的治疗方案，提高手术技能以及做好围手术期的处理是保证手术成功的关键。Objective To investigate the cause, clinic character, treatment and experiences for dealing with the reoperation for biliary duct. Methods The clinical data obtained from 46 patients undergoing reoperation for bile duct diseases in our hospi- tal from January 2003 to December 2012 were investigated retrospectively. Results The operating time was 2.1 - 6.0 h （ mean 4.2 ± 2.2 h ）. Six cases had blood transfusion during the operation, and the blood volume was 200 - 800 ml （ mean 500 ± 100 ml）. The hospital delay was 12 - 38 days（ mean 21.0 - 5.0 days）. There was no death during perioperative period and no serious complications. Conclusion The main cause of biliary duct reoperation after biliary duct multiple operations was bile duct stric- ture. For those complicated eases, preoperative evaluation of patient＇ s condition was accurately done by imaging examination, opti- mal choice of surgical procedures, excellent surgical skills and meticulous perioperative period management were keys to a suc- cessful operation.

关 键 词：胆道再手术 胆道疾病 胆管结石 

分 类 号：R657.4[医药卫生—外科学]