带血管蒂组织瓣在医源性胆道损伤中的应用  

The application of pedicle flap in the treatment of iatrogenic bile duct injury

作　　者：朱震宇[1,2] 段伟宏[1,2] 张克明[1,2] 李志伟[1,2] 王兆海[1,2] 孙百军[1,2] 张培瑞[1,2] 王瑞兰[1,2] 吴建中[1,2] 张绍庚[1,2] 

机构地区：[1]解放军第302医院肝胆外科一中心 [2]解放军第二炮兵总医院肝胆胃肠病研究所,北京100039

出　　处：《肝胆外科杂志》2014年第3期181-184,共4页Journal of Hepatobiliary Surgery

摘　　要：目的探讨带血管蒂组织瓣在医源性胆道损伤中的手术方式及效果。方法对于11例腹腔镜胆囊切除术后胆道损伤的患者,分别使用脐静脉瓣、胃瓣、胆囊瓣、空肠瓣以及圆韧带瓣进行修复。结果胆道修复术采用脐静脉瓣1例、胃瓣1例、胆囊瓣1例、空肠瓣4例以及圆韧带瓣4例。有1例患者术后出现胆瘘。所有患者于出院后肝功能指标及胆道影像学表现均基本正常。结论医源性胆道损伤修复手术为围肝门操作的精细手术。带血管蒂组织瓣修复重建术在恢复胆道连续性以及降低术后并发症方面具有很好的效果。Objective To research the surgical methods and outcomes in treatment of iatrogenic bile duct injury （IBDI） using pedicle flap. Methods There were 11 cases of IBDI repair using pedicle flap including 1 cases of pedicle umbilical vein flap, 1 case of pedicle gastric flap, 1 case of pedicle gallbladder flap, 4 cases of pedicle jejunal flap and 4 cases of pedicled ligamentum teres hepatis. 1 case of biliary leakage occured post-operatively. Liver function and iconography were basically normal when these patients discharged from hospital. Conclusions IBDI repair is a kind of precise and repeated surgery around the hepatic.hilum. The pedicle patch reconstruction has the satisfactory outcome in recovering biliary continuity and lowering post-operative complications.

关 键 词：腹腔镜胆囊切除术 医源性胆道损伤 胆道对端吻合术 胆肠吻合术 带血管蒂组织瓣补片 

分 类 号：R657.9[医药卫生—外科学]