医源性胆道损伤的诊治体会

目的:探讨医源性胆道损伤的原因和处理方法.方法:回顾性分析20例医源性胆道损伤患者的临床资料.结果:损伤类型以胆管横断和部分切除等为多,行胆管-空肠Roux-en-y吻合11例,胆管对端吻合2例,胆管修补2例,胆道引流或单纯腹腔引流5例,其中1例行开腹胆囊切除术(OC)后并发胆瘘,予腹腔引流后出现多脏器功能衰竭死亡,其余均治愈.结论:胆囊切除术是医源性胆道损伤的主要原因,损伤后治疗处理效果重在及时发现,早期处理.

Diagnosis experience of iatrogenic bile duct injury

Objective To investigate the causes and treatment of intraoperative injuries of the bile duct Methods The clinical records of 20 patients with iatrogenic bile injuries were studied retrospectively.Result Most patients suffered from transverse amputation or partial resection of the bile duct. Modified Roux-en-Y choledochojejunostomy was performed in 11 cases,end-to-end anastomosis of bile duct in 2 cases,repair of bile duct in 2 cases,a drainage of the inter bile duct and the abdominal cavity in 5 cases .Only one case of bile duct injury after conventional cholecystectoy with the drainage of abdominal cavity died from multiple system organ failure,all of the other patients were cured. Conclusion The main cause of iatrogenic bile duct injuries was cholecystectomy. It is important for the treating effect to find the injury immediately and treat it early.