【摘要】 目的探讨医源性胆道损伤的预防和诊治方法。方法对 86例医源性胆道损伤的临床资料进行回顾性分析。结果 86例共施行手术 15 6次。其中 2次手术者 6 6例 ,3次手术者 6例。2 2例胆管侧壁损伤行修复 ,胆管内置T形管。 8例是胆总管横断伤 ,行胆肠吻合、T管支撑引流。胆管结扎 9例 ,行结扎线松解 ,T管支撑引流。胆管空肠Roux en Y吻合术 77例。 6 0例获随访 1～ 10年 ,优良率 90 %。结论胆囊切除术是医源性胆道损伤的主要原因 ,是可以避免的。胆管空肠Roux en Y吻合术是医源性胆道损伤或损伤性狭窄修复重建的首选方法。更多还原

【Abstract】 Objective To investigate the etiology of iatrogenic bile duct injury and experience in its diagnosis and treatment. Methods A retrospective study was conducted on the clinical data of 86 patients with iatrogenic trauma in the bile duct. Results These 86 cases have received a total of 156 sessions of surgical procedures, including 2 explorations in 66 cases,3 explorations in 6 cases. Lateral bile duct injury in 22 cases was treated by suture repair and T tube stent. Eight cases suffering from iatrogenic transection of the common bile duct were retrieved by cholangiojejunostomy and T tube stent. Nine cases with inadvertent CBD ligature were managed by a lysis and T tube stent. Roux en Y cholangiojejunostomy was adopted in 77 cases. Sixty cases were followed up for 1～10 years, with good result in 90% of the cases. Conclusions Most CBD iatrogenic injury cases were encountered as a result of cholecystectomy.Roux en Y cholangiojejunostomy is the choice of therapy.更多还原