胆管损伤20例诊断与处理  

Diagnosis and Treatment of 20 Cases Bile Duct Injury Patients

作　　者：何松[1] 

机构地区：[1]湖南省郴州市湘南学院附属医院普外科,郴州423000

出　　处：《中国医药导刊》2013年第10期1593-1594,1596,共3页Chinese Journal of Medicinal Guide

摘　　要：目的：探讨胆管损伤的原因，处理方法和预防措施。方法：回顾分析2002年1月-2012年1月我院收治的20例胆管损伤患者的诊治体会，并总结经验教训。结果：20例均行手术治疗，其中胆管端端吻合3例，单纯缝线拆除2例，胆管壁缺损修补10例，带蒂胆囊瓣修胆管损伤1例，脐静脉瓣修复胆管损伤2例，单纯缝合修补缺损7例，胆管空肠Roux-en-Y吻合5例，无手术死亡。结论：开放胆囊切除，胆总管探查及腹腔镜胆囊切除是胆道损伤的主要原因。胆管损伤关键在于预防，对胆管损伤高危因素的认识，仔细辨认并解剖Calot三角。胆管损伤应不失时机地按不同情况和时间选择合理的手术方法进行治疗。Objective：Discuss the cause of bile duct injury, treatment methods and preventive measures.Methods：Retrospective analysis of diagnosis and treatment in 2002 January to 2012 January in our hospital 20 cases of bile duct injury experience,experience and lessons.Results：All 20 cases underwent operation treatment,including bile duct end-to-end anastomosis in 3 cases,the removal of suture in 2 cases,10 cases of bile duct wall defect repair,with pedicle gallbladder flap repair of bile duct injury in 1 cases,2 cases of umbilical vein graft in the repair of bile duct injury,simple suture repair defect in 7 cases,bile duct jejunum Roux-en-Y anastomosis in 5 cases,no operation death.Conclusion：Open cholecystectomy,common bile duct exploration and laparoscopic cholecystectomy was the main cause of bile duct injury.The key lies in the prevention of bile duct injury,risk factors of bile duct injury,careful identification and dissection of Calot triangle.Bile duct injury should be treated according to the operation method of the different time and the selection of reasonable seize the opportune moment.

关 键 词：胆管损伤 处理 预防 

分 类 号：R657.4[医药卫生—外科学]