【摘要】 目的 探讨胆囊切除致胆管损伤的原因及防治方法。方法 回顾性分析近10年诊治的12例胆管损伤。结果 12例中8例为术中发现;7例见病理及解剖异常。肝、胆总管破损5例,结扎切断7例。分别行修补、胆管端端吻合T管支架引流及胆管空肠Roux-en-y吻合术,再手术1例。全组治愈。结论 提高对胆囊切除致胆管损伤的高危因素的认识,仔细辨认并解剖Calot三角,必要时行胆囊及其颈部的特殊处理,有助于减少胆管损伤。更多还原

【Abstract】 Objective To investigate and analyze the iatrogenic bile duct injury caused by cholecystectomy on the cause, diagnosis, treatment and prevention. Methods The 12 cases due to bile duct injury at surgery, treated in our hospital, were reviewed retrospectively from 1992 to 2002. Results Among all of the 12 cases, the 8 cases were discovered during the operation, and the 7 cases related to the abnormal anatomy of bile duct and pathological changes around the bile duct. They were supported and drained by T -shape tube before or after the end - to - end anastomosis and a biliary - enteric anastomosis with a Roux - en - Y limb of jejunum, one case of patients got cured from restricture operation. All of the 12 cases were cured without any sequelace. Conclusions In addition to being careful in identifying the anatomy of Calot’s triangle, the correct operational procedure and management of incarcerated gallstones in neck of gallbladadder. We should be keep in mind with the high risk factors during cholecystectomy to reduce iatrogenic injury of the bile duct.更多还原