医源性胆管损伤的诊治体会

目的探讨手术中胆管损伤后即时手术和再次手术处理的方法。方法回顾性分析1984年5月-2003年11月经作者手术或参与手术21例的临床资料。结果术中即时发现并处理6例。其中，成功4例，术后狭窄再次手术治愈1例，处理结果不满意1例。术后处理15例，均择期行胆肠吻合治愈。结论术中处理结果与损伤程度和胆管横径大小密切相关。术后因各种原因导致胆管狭窄者应行胆管空肠吻合术。

Experiences in diagnosis and treatment of iatrogenic bile duct injury

Objective To summarize the experiences in the management of immediate primary operation and secondary re-operation following intra-operative bile duct injury.Methods The clinical data of 21 patients on whom the author operated or participated in the operations from May 1984 to November 2003 were retrospectively analyzed.Results Of the 21 patients,6 were managed intra-operatively after timely finding of bile duct injury.Among them,4 were successful,1 recovered after re-operation due to post-operative bile duct stricture,and 1 was not satisfactory.Fifteen patients were all cured by selective biliary-enteric anastomosis after primary operation.Conclusion The results of intra-operative management were closely related to the degree of bile duct injury and the diameter of the bile duct.Biliary-jejunal anastomosis should be performed if post-operative bile duct stricture occurs.