胆道再次手术的原因与对策(附123例分析)

目的:探讨胆道再次手术的原因,寻求预防对策。方法:回顾性分析1998年2月至2007年1月收治的123例胆道再次手术的临床资料。结果:胆道再次手术的主要原因是肝胆管结石残留或复发,占本组资料的67.5%(83/123);其次是残余胆囊占17.1%(21/123);医源性胆管损伤占5.7%(7/123);胆管狭窄占2.4%。结论:胆道首次手术尽量减少或消除结石残留,充分利用内镜技术,强化对胆道手术潜在危险性的认识,并规范操作是降低胆道再次手术率的重要因素。

Causes and strategies for secondary biliary tract operation: A report of 123 cases

Objective:To investigate the causes of secondary biliary tract surgical intervention for preventive measures. Methods:The clinical data of 123 cases undergone re-operation on biliary tract from Feb.1998 to Jan. 2007 were included in this retrospective investigation. Results: Re-operation resulted generally from residual products or recrudesce of gallstones in bile ducts(67.5%,83/123)followed by residual gallbladder(17.1%,21/123). Iatrogenic bile duct injuries and stenosis of bile duct accounted for 5.7% and 2.4%,respectively. Conclusion: It is essential to reduce re-operation rate by removing the stones completely in the first operation or by means of endoscopic ultrasonography for supporting detection of the stones, and surgeons should be taught with standard procedures.