摘要
目的总结损伤性胆管狭窄的临床资料，对损伤性胆管狭窄的治疗效果进行评价。方法对过去14年我院收治的48例损伤性胆管狭窄原因、原手术术式、近期感染、并发症发生率，支撑管支撑时间和随访结果进行回顾性分析。结果本组损伤性胆管狭窄发生于胆囊切除术的36例（其中腹腔镜胆囊切除术12例），胆囊切除＋胆总管探查术9例，其余3例为肝破裂修补术后。狭窄胆管修复过程中，25例行肝管空肠吻合，6例行胆总管空肠吻合，胆管对端吻合3例，狭窄段胆管或吻合口整形14例。发生围手术期并发症14例，其中切口感染11例。随访时间13个月～10年，平均57个月。随访病例优良率是90％，预后差者4例，其中1例死亡。结论掌握好适应症，肝管空肠吻合术和整形都能取得良好效果。
Objective To evaluate clinical effects of traumatic biliary stricture by collecting traumatic biliary strictures treated in tianjin Nankai hospital in recent 14 years. Methods To analyse the cases of traumatic biliary strictures by retrospective methods. A total of 48 patients underwent surgical reconstruction during 14 years. Results The main cause was the biliary strictures after cholecystectomy（36 patients,of whom 12 patients had been performed LC）. The second main cause was reoperation for cholecystectomy with common bile duct exploration（9 patients）. The less frequent cause was exploration for liver injury （3 patients）. In reoperation, 125 patients underwent biliojejunostomy, 14 patients received simple strictureplasty. In perioperation, there were 14 patients occurring complications, and of whom wound infection occurred in 11 cases, but no death, 40 patients were followed-up for a mean period of 57 months, most of them（90% ） had a successful outcome, and didn＇t need any invasive diagnostic and therapeutic procedures. Only 4 patients had poor results,of whom one died of biliary cirrhosis. Conclusion Both bilioje junostomy and strictureplaty had good results.
出处
《肝胆外科杂志》
2007年第4期253-255,共3页
Journal of Hepatobiliary Surgery
关键词
损伤性胆管狭窄
胆囊切除术
traumatic biliary stricture
cholecystectomy
