插入式胆肠吻合术治疗医源性胆道损伤27例

目的 评价插入式胆肠吻合术在医源性胆道损伤一期胆道重建中的临床应用效果.方法 对1995年1月-2006年12月施行的27例插入式且胆肠吻合术的病例资料进行回顾性分析.结果 27例中,开腹胆囊切除致胆管损伤21例,腹腔镜胆囊切除致胆管损伤6例.损伤的胆管直径均小于1.0 cm(0.3～0.8 cm).行胆管全插入式胆肠吻合10例,胆管前壁插入式胆肠吻合17例.术后无1例发生胆瘘和胆管狭窄.结论 插入式胆肠吻合术简单、安全、有效.在胆管较细且需要做胆肠吻合术的病例,应选择此术式.

The "inserting" bilio-jejunostomy for iatrogenic bile duet injury

Objective To evaluate the usefulness of the "inserting" bilio-jejunostomy for iatrogenic bile duct injury. Methods A retrospective analysis was performed on 27 cases with iatrogenic bile duct injury treated by the "inserting" bilio-jejunostomy in the past 11 years. Results Among the 27 patients, bile duct injury was caused by open cholecystectomy in 21 and by laparoscopic cholecystectomy in 6. The diameter of injuried bile ducts in all patients was less than 1 centimeter (0.3～0.8 cm ). The end of remnant bile duct 2～3 cm in length was completely inserted into the jejunum loop in 10 cases, while the anterior wall of the remnant bile duct inserted into jejunum loop with the posterior wall anastomosed with the jejumum conventionally in 17 cases. There was no biliary fistula nor stenosis occurred after the operation. Conclusions The "inserting" bilio-jejunostomy is a simple,safe and useful method, and this new surgical technique should be applied to patients with iatrogenic bile duct injury when bilio-enteric reconstruction was needed.