19例拔除T管致胆漏治疗分析

目的:探讨拔T管致胆漏的原因及防治策略。方法：对1990年1月至1999年12月收治的19例拔T管致胆漏的病人作回顾性分析。结果：19例首选非手术治疗，3例中转手术治疗非手术治愈率为84％（16／19），3例手术病人亦治愈，全组无死亡病例。结论：拔T管致胆漏与病人的全身情况及术中、术后细小环节的技术操作是否严格要求及是否规范有关。胆漏发生后应视胆漏大小、病情轻重选择非手术与手术治疗。预防应从手术前、中、后三个环节着手。

Analysis and treatment of 19 cases with bile leakage after removal of a T tube

Objective: To investigate the cause,prevention and treatment of bile leakage after removal of a T tube. Method: The clinical date of 19 cases with bile leakage after removal of a T tube treated from Jan 1990 to Dec.1999 were reviewed retrospectively.Results: Of the 19 cases treated with non-operative therapy, 3 patients were transferred to be operated later ,the cure rate of non-operation was 84% (16/19). 3 cases who were transferred to be operated later were finally cured. No patient died in all cases. Conclusion: Bile leadage after removal of a T tube is mainly related to atiebt's body condition and manipulation in operative manage or postoperative treatment. Different treatments are optional according to prevent it. surgeons should pay more attention to the 3 links of primary procedure, including preoperative preparation operative managemtment and postoperative treatment.