摘 要目的:总结胆囊切除术中胆道损伤的原因及Ⅰ期处理方法。方法:对我院1996.1至2009.1行Ⅰ期处理的41例胆囊切除术中胆道损伤的临床资料进行回顾性分析。结果:采用胆管直接缝合修补9例、肝圆韧带修复5例、胆囊浆肌瓣修复2例、胆管端端吻合8例、胆管-空肠Roux-en-Y吻合17例,所有病例均置T管和腹腔引流管,皆获痊愈出院。其中5例因胆管狭窄再次手术。总优良率87.8%(36/41)。结论:提高对胆囊切除术的认识是预防胆道损伤的关键;及时发现并根据胆道损伤情况进行合理的修复,则预后较好。

    关键词胆囊切除术;胆道损伤;Ⅰ期处理

    中图分类号:R 657.4文献标识码:B

    AbstractObjective:To summarize the causes of biliary injury in cholecystectomy and the experience of one-stage treatment. Method:The clinical data of 41 biliary injuries underwentrepair at initial operation from january 1996 to january 2009 were analysed retrospectively.Results:Of those, 9 cases underwent bile duct suture directly , 5 cases repaired with teres ligament, 2 case with gallbladder wall, bile duct end-to-end anastomoses andRoux-en-Y hepaticojejunostomy were performed on 8 and 17 cases repectively, T-tube and celiac drainage tube were used conventionally. All patients discharged from hospital with no complications occured . 5 cases underwent re-operation because of biliary stricture, and the overall good-rate attain to 87.8%. Conclusions:To enhannce the cognition of cholecystecomy is critical for avoiding bile duct injury, and the prognosis is good when bile duct injury discovered in time andrepaired properly. ......