胆总管囊肿切除术中胰管损伤的防治

目的探讨胆总管囊肿切除术中胰管损伤的处理及预防。方法 分析手术处理５例胰管损伤的临床资料。结果 ５例胰管损伤中行胰管修补３例、胰管十二指肠吻合１例及副胰管结扎１例；术后４例效果满意，１例胰漏经保守引流治愈。结论 术中造影可清楚显示胆胰管连接系统，指导胆总管囊肿根治切除术离断 胆胰管连接部水平，避免损伤胰管。对胰管损伤者应行胰管修复或重建术。

Prevention and treatment for pancreatic duct injury during the excision of choledochal cyst

Objective To evaluate the management and prevention of pancreatic ductal injury during the excision of choledochal cyst (CC). Methods From 1980 to 1999, 112 children with CC underwent hepaticoduodenostomy after excision of the cyst.The clinical materials of 5 cases with pancreatic duct injury were analyzed retrospectively. Results Of them, 3 cases were performed on primary repair, one case on parcreaticoduodenostomy and one on accessory pancreatic duct ligation. Four of them recovered satisfactorily, one had pancreatic fistula healed up by conservative therapy. Conclusions With the intraoperative cholangiopancreatography (ICP), the entry points of the common bile duct and pancreatic duct, the level of cyst resection must be identified in order to prevent the pancreatic duct injury . A primary repair or reconstruction of the pancreatic duct should be followed in case of injury.