T管窦道破裂或愈合不良19例原因分析与处理

目的分析T管窦道破裂与愈合不良的原因，并总结其治疗经验。方法回顾性分析1993年7月-2003年7月间术后纤维胆道镜发现的13例T管窦道破裂与6例窦道愈合不良病人的临床资料。结果13例T管窦道破裂病人中11例发生在取石操作时，2例发生在重置T管时；6例窦道愈合不良病人中均未发现明显影响创伤愈合的全身性因素存在。全部病人均通过内镜处理获得痊愈。结论较大而坚硬的结石与不当操作易致T管窦道破裂，而T管窦道愈合不良可能与病人自身愈合能力有关；适宜的内镜处理可避免再次手术。

Analysis and Treatment of Rupture and Malunion of T-tube Sinus (with Report of 19 Cases)

Objective To study the cause and management of rupture and malunion of T-tube sinus. Method 13 cases of T-tube sinus rupture and 6 cases of T-tube sinus malunion diagnosed by postoperative choledochoscopy were retrospectively studied from July 1993 to July 2003. Result 11 cases of T-tube sinus rupture occured in the course of stone extraction, the rest 2 cases in T-tube replacing. There was no significant systemic factor associated with malunion of the 6 cases of T-tube sinus. All patients endoscopically cured. Conclusion Large, hard stone and unfavorable manipulation are highly associated with T-tube sinus rupture, T-tube sinus malunion may induced by poor healing potentiality. Reoperation can be avoided by appropriate endoscopic management.