【摘要】 目的总结医源性胆管损伤的原因、预防及处理经验。方法对21例医源性胆管损伤的临床资料进行回顾性分析。结果本组21例病例中,痊愈出院17例(81%),死亡1例(4.8%),死亡原因为胆汁性腹膜炎导致的感染中毒性休克。3例术后晚期胆管狭窄患者,经单纯的ERCP扩张并置支架内引流,效果不佳,自动放弃手术治疗。术后存活的17例患者中,术后1年有3例出现胆管炎反复发作,影像学证实为胆管再狭窄,经再次手术后痊愈。结论提高对医源性胆管损伤的认识和术中细致的解剖是预防的关键。胆管空肠吻合术是医源性胆管损伤或损伤性胆管狭窄的修复重建的主要手段。更多还原

【Abstract】 Objective To investigate the causes, prevention and treatment of iatrogenic bile duct injury. Methods The clinical data of 21 patients with iatrogenic bile duct injury were analyzed retrospectively. Results Among the 21 patients, 17(76%)were cured,3 poor(14.3%) and 1 died(5%). Eighteen patients(85.7%) were followed up for 24±5 months.Three received reoperation due to biliary stricture after 1 year. Conclusion To in improve understanding of iatrogenic bile duct injury and meticulous operative manipulation are very important to prevent intraoperative injury of bile duct. cholangiojejunostomy is a principal measure for the repair and reconstruction of iatrogenic bile duct injury or traumatic bile duct stenosis.更多还原