内镜诊治医源性胆道损伤效果评价

【目的】初步探讨内镜下治疗在医源性胆道损伤中的临床应用及治疗效果。【方法】以胆道与消化道连续性是否存在,决定医源性胆道损伤患者首选内镜或手术治疗。【结果】于2005年6月-2010年12月间发现医源性胆道损伤54例,术中发现胆道损伤而行相应治疗4例,术后发现胆道损伤50例(其中A型38例,C型1例,D型7例,E型4例),针对胆道损伤的分型行内镜下治疗41例(1例内镜治疗失败再次手术),直接再次手术4例,所有患者治疗后临床症状均明显改善,无严重并发症发生。【结论】应用内镜对于医源性胆道损伤的诊断与治疗安全有效,胆道并发症的较快发现及处理可使患者较快治愈。

Diagnosis and treatment of iatrogenic biliary injury by endoscopic retrograde cholangiopancreatography

【Objective】To investigate the value of ERCP in treatment of iaotrogenic biliary injury.【Methods】ERCP or surgical treatment was performed according to continuity of bile duct or gastrointestinal tract.【Results】54 cases of iatrogenic biliary injury had been found during June 2005 to December 2010.4 cases were diagnosed in bile duct injure during the operation and received corresponding treatment.50 cases were bile injury post-operation which was divided into A,C,D and E type including 38,1,7 and 4 cases,respectively.41 cases underwent the ERCP according to the injury type,1 of them were suffer from the surgical operation because of the fail on ERCP.The other 4 cases received operation directly.There was no severe complication occurred and the clinical symptoms were improved significantly.【Conclusion】ERCP was a safe and effect for iatrogenic biliary injury.Timely diagnosis and treatment of biliary complications were accelerating the recovery of disease.