肝胆外科手术后27例胆漏的原因分析及防治

目的分析肝胆手术后发生胆漏的原因，探讨其防治对策。方法回顾性分析近5年在我科实施的肝胆外科手术1531例，发生胆漏27例（1．76％）。根据我国肝胆外科手术后发生胆漏的主要原因，从以下三个方面作统计学分析：手术部位分析分为胆部操作与肝部操作；主客观分析，分为主观原因与客观原因；年龄分析，分为〉45岁及≤45岁。结果27例胆漏并发症中，21例保守治疗，4例行腹腔镜手术治疗，1例行B超下穿刺导管引流术治疗，1例中转开腹手术治疗。结论手术操作技术及经验的欠缺是发生术后胆漏的主要原因，术前应详细分析病变部位的病理及解剖。从而预防术后胆漏发生。

Postoperative bile leakage and the prevention:an analysis of 27 cases

Objective To analyze the causes of bile leakage after surgery.Methods A retrospective analysis of the past 5 years in our department to implement the 1 531 cases of hepatobiliary surgery,bile leakage occurred in 27 cases(1.76%).According to the common reasons of bile leakage after surgery,make the following three statistical analysis: surgical site analysis,operation of liver and bile;Subjective and objective analysis,divided into subjective and objective reasons;Age analysis,divided into > 45 years and ≤ 45 years of age.Results Twenty-seven patients with biliary leakage complications,21 cases of conservative treatment,4 cases of laparoscopic surgery,a routine B-percutaneous catheter drainage in the treatment,1 patient conversion to surgery.Conclusion Surgical technique and the lack of experience is the main reason for postoperative bile leakage.The preoperative and pathologic anatomy of the lesion are analyzed in detail,thus preventing bile leakage occurred.