胆道结石再手术31例治疗分析

目的对胆道结石再手术发生的原因、治疗方式及疗效进行临床分析，以期避免或减少胆道残留结石的发生并提高疗效。方法总结2008年以来本院普外科收治的各类胆道结石患者术后再次胆道手术病例31例，从胆道结石手术后再次手术的原因、处理方法及治疗效果等方面进行分析。结果30例术后无并发症，痊愈出院；1例术后并发胆道感染经抗炎对症治疗后出院。结论胆道再手术主要原因是胆道残余结石，并与结石的部位、胆道的病理改变、手术方式的选择、手术的合理操作、术者的经验、探查指征的掌握、患者的全身情况等多种因素有关。其中，多次胆道再手术的原因则以胆管和胆肠吻合口狭窄为主。胆道再手术以清除结石、纠正胆管狭窄和建立通畅引流为原则。

Clinical analysis of reoperations in 31 patients with cholelithiasis

Objective To study features and causes of biliary duct re-operations and evaluate their therapeutic efficacy for avoiding its occurrence and decreasing its number. Methods 31 cases of the clinical data of all the patients receiving bile duct re-operations in our hospital from 2005 were retrospectively analyzed. Results 30 cases have no surgical operation complications, I with bile inflammation was cured by anti-infective. Conclusion The main cause for re-operations is bile stone, and combine with various factor such as the stones location in the dust, surgical operation of the pathologic change, the reasonable operation, indications of the exploration, the surgical operation method, the experience of the doctor, the whole body circumstance of the patient setc. Stricture of bile duct and anastomosis is the most common cause for repeated re-operations. The purpose of re-operations is to clean up stones, correctstrictures and build pathway for bile flow.