摘要
本文总结我院１９８０年～１９９０年收治的医源性胆管损伤３５例，（其中我院手术所致１１例，占同期２６７９例胆囊切除术的０．４１％，损伤部位以肝总管与胆总管交界处最多（２８／３５）。损伤的原因有：手术者麻痹大意、麻醉不佳、切口选择不当、助手不得力、局部粘连或有较大出血、解剖变异等。预防关键在于充分认识胆囊切除术的潜在危险，熟悉局部解剖关系，充分估计操作中的困难，选择适当的麻醉及得力助手。根据损伤的不同时间及类型决定治疗原则。
In this article, we presented 35 cases of bile duct injuries following cholecystectomy,treated in our hospital during past ten-years period (from 1980 ～ 1990). Among them 11 cases were treated in our hospital, and there were 2679 times cholecystectomy underwent in our hospital in the same period,the morbidity was 0.41%. The most frequent part of bile duct injuries was located in the juncture of three ducts(common hepatic duct,cystic dust and common bile duct).The most common type of injuries were partial duct wall injuries other than bile duct crosscuting. The bile duct injury is the most serious complications following cholecystectomy. In study their reasons, the most parts of injuries resulted from carelessness of the surgeon other reasons were unsatisfactory anesthesia,inappropriate incesion,insuffcient exposure to operation field, unqualified first assistant, and bile duct variations, all these factors made operation difficult.In prevention, it is most important to take cholecystectomy seriously, to have an intimate knowledge of normal biliary tract anatomy and its variations , to foresee the difficulties in operations according to history ,to chose appropriate anesthesia and qualified first assistant in order to get sufficient exposure. In treatment, the principles of the treatment were decided in consideration of type of injuries and time elapse after injuries, the most satisfied ultimate treatment was high level Roux-y biliary-enteric anastomosis.
出处
《西安医科大学学报》
CSCD
1994年第3期295-297,共3页
Journal of Xi'an Medical University(Chinese)
关键词
胆囊切除术
胆管损伤
胆肠吻合术
吻合术
cholecystectomy, bile duct injury, biliary-enteric anastomosis
