摘要
医源性胆管损伤是胆囊切除术后的严重并发症之一,大部分病人须行再手术治疗。再手术主要包括初次修复和多次修复失败后再修复两种情形。术前须对病人进行全面评估,在准确分型的基础上进行术式的合理选择,术中应规范胆肠吻合手术操作,把握分离粘连、显露肝门、胆管成形等主要步骤的技术要点,尽量保证胆管损伤修复的长期疗效。
Iatrogenic bile duct injury is one of the most serious complications after cholecystectomy. Most patients require surgical repairs, mainly including primary repair and repeated repair. Preoperative patient preparation is essential to control inflammation or intra-abdominal fluid collection, restore the nutritional status, and improve the functional status. The management of bile duct injuries will depend on the nature and the extent of injury, which can be precisely evaluated by Strasberg classification system. Surgeons should follow the basic biliary-enteric anastomsis principles to achieve optimal outcomes. The key steps for repair include adhesion clearance, hilas exposure, and biliary reconstruction. There is a need to not only use widely accepted standards but also to assess the long-term biliary patency.
作者
张永杰
王向
ZHANG Yong-fie;WANG Xiang(No.2 Department of Biliary Surgery,Eastern Hepatobiliary Surgery Hospital,the Second Military Medical University,Shanghai 200438,China)
出处
《中国实用外科杂志》
CSCD
北大核心
2018年第9期1017-1020,共4页
Chinese Journal of Practical Surgery
