小儿巨大肝肿瘤切除术胆道损伤的临床分析（附2例报道）

目的分析小儿巨大肝肿瘤切除术发生胆道损伤的原因，探讨预防胆道损伤及损伤后修复的方法。方法对2例肝肿瘤手术并发胆道损伤患儿进行回顾性分析。结果1例术中损伤健侧胆管，并术后胆漏，经创面引流后，行胆管整形、R0ux-en-Y胆肠内引流，T管引流。目前已存活10个月。另1例术后黄疸，PTCD术后黄疸消退，未再手术。术后二个月肺转移。结论为避免胆道损伤，术中应操作仔细。仔细辨别肝门部解剖关系。发现胆道损伤，应根据损伤部位、类型、程度、特点，采取不同方式修复胆道损伤。

Prevention and treatment of bile duct injuries during child hepatectomy

Objective To analyze the causes and to discuss the prevention and treatment of iatrogenic bile duct injury during child hepatectomy. Methods and Results The clinical data of 2 cases of bile duct injuries were retrospectively analyzed. Of the 2 cases, 1 was iatrogenic injuries, underwent cholangiotomy plastic surgery, and Roux - en - y choledochojejunostomy with drainage. Bile leak occurred in this case, and follow - up show that the child is alive. Another case showed jaundice after operation bile duct stricture occurred. PTC drainage and jaundice disappearance. Conclusions Great efforts should be made to avoid bile duct injuries. The injuries should be promptly found if there are any in clinical practice. The injuries should be repaired by different means according to their position, type, degree, and festure.