医源性肝外胆管损伤的处理

目的 总结医源性胆管损伤的处理经验。方法 对５４例肝外胆管损伤处理进行回顾性分析。结果 ５４例中６例为腹腔镜胆囊切除术损伤，４８例为开腹胆囊切除术损伤。术中及时发现１８例（３３．３％）。术后２４ｈ后发现２４例（４４．４％），手术１个月以后发现１２例（２２．３％）。５４例经道次处理后２３例（４２．６％）治愈，２８例（５１．９％）经过２次以上胆管手术，死亡３例（５．６％）。结论 正确掌握胆管损伤的处理

Treatment of iatrogenic extrahepatic bile duct injuries

Objective To summarize the experience in therapy of iatrogenic bile duct injuries(IBDI). Methods A retrospective study was made on the treatment of 54 patients with IBDI. Results Six cases of them were damaged by laparoscopic cholecystectomy(LC), and the others by open cholecystectomy. 18 cases(33.3%) were found during the operations; 24 cases(44.4%) were found more than 24 hours after operation; 12 cases(22.3%) were diagnosed a month later after operation. Thirty three of the 54 cases got curative effects after the reoperation, 28 having 2 or more times operations. Three patients died after reoperation. Conclusions Correctly handling the principle and means of IBDI therapy, and realize the characteristics of IBDI of LC are important for treatment of IDBI. Roux en y cholangiojejunostomy is the best effective treatment for IBDI.