损伤性肝外胆管狭窄45例临床分析

目的：分析损伤性肝外胆管狭窄发生的原因和损伤后狭窄的修复术式选择。方法：损伤性肝外胆管狭窄45例，诊断方法以B超，PTC、ERCP为主，全组分别行胆管空肠吻合术，胆管十二指肠吻合术，肝门胆管整形术等手术治疗。结果：随访36例，末次手术行胆管空肠吻合术33例，优良87.9%。结论：可见性损伤和隐性损伤所致的瘢痕收缩是胆道狭窄的主要原因，损伤性肝外胆管狭窄的治疗方法以胆管空肠Y形吻合术较为理想。

Clinical analysis on 45 cases of traumatic stricture of extrahepatic biliary tract

Objective: To discuss emphatically the main causes of late stricture of biliary tract and its better therapeutic means. Methods: 45 cases of traumatic stricture of extrahepatic biliary tract were reported. The main diagnostic methods included B ultrasonography, PTC and ERCP. The surgical treatment was performed in all patients by cholangiojejunostomy, cholangiodenduostomy and cholangiohepatoplasty. Result: Thirty six patients were followed up, and the long term results of cholangiojejunostomy were good in 87.9% of them. Conclusion: The visible injury and cicatrical contracture of latent injury were main causes of late stricture of biliary tract. Roux en y cholangiojejunostomy, when taken as the surgical repair method, affords better therapeutic results.