胆囊切除术中胆管损伤12例分析

目的分析胆囊切除术中胆管损伤原因,探讨有效地预防措施及正确的处理方法。方法回顾性分析我院12例胆囊切除术致胆管损伤的原因及处理结果。结果横缝修补1例,端端吻合7例,胆肠吻合4例,其中胆管空肠Roux-en-Y吻合3例。1例患者术后1年反复胆管感染再次手术行胆管空肠Roux-en-Y吻合,余11例患者术后无胆瘘和胆道狭窄发生。本组12例无一例死亡。结论术中解剖不清、盲目止血是损伤发生的根源。胆管损伤重在预防,一旦发现损伤需及时正确处理,否则将造成严重后果。手术者应保持警惕、遵循胆囊手术处理原则、规范手术操作。

The clinical analysis of Cholecystectomy bile duct injury (12 cases reports)

Objective To analysis the reason of cholecystectomy bile duct injury and explore effective preventive measures and the correct way to deal with. Methods Retrospective analysis of the reasons for cholecystectomy bile duct injury and results of treatment of all of 12 cases in our hospital. Results Repair joints 1 case, 7 cases of end to-end anastomosis, 4 cases of biliaryenteric anastomosis, in which bile duct jejunum Roux-en Y anastomosis in 3 patients. Example 1 after 1 year in patients with bile duct infection repeated reoperation line duct jejunum Roux en-Y anastomosis, more than 11 cases of patients with non-biliary fistula and biliary stricture happen. Conclusions Intraoperative anatomy unclear, blind hemostasis are the root causes of injury. Focus on the prevention of bile duct injury, once the injury was found to be correct and timely treatment, they would have serious consequences. Surgery should remain vigilant, following gall bladder surgery treatment principles, norms operation.