胆道再手术原因分析：附828例报告

目的:分析导致再次胆道手术的原因，以期减少胆道再手术率。方法:总结1990—1999年间收治的再次胆道手术患者828例的临床资料，对胆道疾病再次手术的原因进行归类分析。结果:再手术的主要原因是结石复发或残留，占65.10%;结石合并Oddi括约肌狭窄占33.82%;单纯Oddi括约肌狭窄占9.54%;胆管损伤性狭窄和胆肠吻合口狭窄占10.39%;胆道系统肿瘤占6.52%。结论:胆道再手术的主要原因仍以结石复发或残留为主，其次为Oddi括约肌狭窄;损伤性胆管狭窄等与手术有关的因素不容忽视。减少胆道再次手术的关键在于初次手术的彻底性和手术方法的合理性。

The causes for biliary duct reoperations: a report of 828 cases

Objective To study the causes of reoperation after biliary duct operation, in order to decreasing the rate of biliary tract reoperation. Methods The clinical data of 828 patients who underwent reoperation of biliary duct diseases in Nankai hospital between 1990-1999 were evalated, and the causes of biliary duct reoperation were classified and analysed.Results The most common cause for reoperation was recurrent or retained bile stone(65.10% ), bile stone companied by stenosis of the sphincter of oddi (33.82%), simple stenosis of sphincter of Oddi ( 9.54%), traumatic stricture of bile duct and stricture of bilioenteric anastomosis( 10.39%), bile duct obstruction due to tumor (6.52%), and other less important factors. Conclusions Recurrent or retained bile duct stone was the main cause for biliary reoperation,and stenosis of the sphincter of Oddi was the next important factor for reoperations.Thoroughness of the initial operation and rationality of operative procedure are the chief factors to decrease bile duct reoperations.