医源性胆管损伤的体会(附23例报告)

目的探讨医源性胆管损伤的原因与防治。方法主要诊断方法为B超、瘘管造影、MRCP和ERCP检查。术中确诊后行胆管对端吻合或胆管空肠Roux-Y型吻合术。结果本组6例行胆管对端吻合,效果最好;17例行胆肠吻合,其中7例效果较好,5例偶有腹痛,2例反复发生胆管炎,1例死亡。结论应重视医源性胆管损伤,合适处理是避免并发症及后遗症的关键。

Comprehension of iatrogenic bile duct injury (a report of 23 cases)

Objective To explore the cause of iatrogenic bile duct injury, its prevention and treatment. Methods The main diagnostic method were B-type ultrasound, fistulography, MRCP and ERCP examinations. When the bile duct injury diagnosed, end-to-end anastomosis of the injured duct or jejuno-biliary ducts anastomosis were performed immediately. Results In this group, 6cases end-to-end anastomosis of the injured duct recovered soon and had better effect; 17 cases jejuno-biliary ducts anastomosis were as follows: 7cases had good results, 5cases were with seldom abdominal pain, and 2patients had repeat cholangitis, 1 case died. Conclusion It is important to pay attention to iatrogenic bile duct injury, to treat it properly can avoid complications and sequelae.