医源性胆管损伤的原因和处理

目的 探讨医源性胆管损伤的原因及防治方法.方法 回顾分析内蒙古医学院第一附属医院1998年1月-2008年12月诊治的胆管损伤病例48例,均为胆囊切除术中损伤.结果 在术中、术后早期和晚期发现胆管损伤,均予不同方法处理,本组46例好转或痊愈出院,手术病死率为4.2%.35例经平均3年以上的随访,效果优良率达91.4%.结论 胆囊切除术中胆道损伤难以完全杜绝,应提高对胆管损伤高危因素的认识,仔细辨认并解剖Calot三角,胆管损伤时按不同情况和时间选择不同方法手术治疗.

Causes and management of iatrogenic bile duct injury

Objective To investigate the causes,diagnosis,treatment and prevention of iatrogenic bile duct injury by cholecystectomy.Methods Forty-eight cases due to bile duct injury in cholecystectomy,treated in First hospital afliliatcel to Inner Mongolia Medical College,were reviewed retrospectively from 1998to 2008.Results The bile duct injures were managed by different treatments early or late after operation.Forty-six cases were cured and moratality rate was 4.2%.Thirty-five patients were followed up for 3 years on average,and the effective rate was up to 91.4%.Conclusions Bile duct injury is rare but still one of the most common complications after cholecysteetomy.We should keep in mind the hiigh risk factors during cholecystectomy,careful in identifying the anatomy of Calot's triangle,chosing the treatment of bile duct injuries according to the different time and the different types.