开腹胆囊切除术致胆管损伤的原因及处理

目的 探讨开腹胆囊切除术致胆管损伤的原因、处理。方法 回顾性分析11例开腹胆囊切除术所致胆管损伤。结果 胆管损伤的原因有人为因素和客观因素，包括胆道解剖变异、局部病理因素、手术操作不当等。损伤发生后应据具体情况，给予直接缝合修补、对端吻合、胆肠吻合、T管引流等。结论 提高医生对胆管损伤的警惕性，注意规范手术操作，熟悉胆道解剖，掌握各种切除胆囊的方法。胆管损伤发生后应及早诊断，并根据损伤发现的时间、部位、类型选择合理的处理方法。

Treatment and causes of the bile duct injuries in open cholecystectomy

Objective To discuss the canses and trentments for the bsle duct injuries in open cholecystectomy. Methods Retrospective study of 11 patients of the bile duct injuries in open cholecystectomy. Results The causes of the bile cluct injuries relaied to the doctors and patient's condition, which include the abrormal anatomy of bile duct, pathological changes around the bile duct, and the wrong operation. It was important to recognize the bile duct injuries during the original operation and immediately give repairs such as directg repair, end-to-end bile duct repair and biliary-enteric anastomosis with a Roux-en-Y limb of jejunum, or the T-tube drainage and chosing different treatment according to the practical conditions after operation. Conclusions In order to decrease the morbidity of bile duct injury, doctors should perform operations constraintly. Solid understand the anatomy of bile duct and acquire all the methods of remoral the gallbladder. When the bile duct injnries occurred, it was important for immediate diagnosis and chosing suitable treatments according to the times of finding the injuries, the postions, the types, etc.