胆道再手术36例临床体会

目的:探讨胆道再手术的原因及治疗方法。方法:回顾36例胆道再手术患者的临床资料,对再次手术的原因、处理方法及治疗效果等方面进行系统的分析比较。结果:胆道再手术病因以肝、胆管结石复发和残留居多(75.0%),其次为Odd′is括约肌狭窄或功能不全(11.1%)。经治疗痊愈35例,死亡1例,治愈率97.2%。结论:胆道再手术主要原因是胆管结石残留和复发,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。选择好手术时机、手术方式、规范手术操作及加强围手术期管理是减少胆道再手术率及并发症发生的关键。

Clinical analysis on 36 patients underwent bile duct re-operation

Objective To summarize the causes and surgery method of biliary duct re-operation.Method The clinical data of 36 patients underwent bile duct re-operation were retrospectively analyzed and its causes,surgery method and therapeutic efficacy were summarized.Results The most common cause for re-operation was regenerated and residual stone,the next was stenosis or dysfunction of Oddi′s sphincter.For 35 cases of 36 were cured and only 1 case died of liver failure.Conclusion The main cause for re-operations is bile stone and the principle of re-operations is cleaning up stones,correcting strictures,building pathway for bile flow.The key of decreasing bile duct re-operation and complication is correct choice of surgery chance and method,reasonable operation procedure and perioperative managements.