摘要
医源性胆管损伤及其导致的损伤性良性胆管狭窄是胆道手术后最为棘手的并发症.在开腹手术时代,胆管损伤的发生率为0.1％ ～0.2％,而在腹腔镜时代则上升至0.2％～0.4％[1-3].胆管损伤的发生导致患者的并发症发生率和病死率大幅度升高,加上随之而来的纠纷和诉讼使得医患双方均陷入痛苦之中.胆管损伤发现不及时或处理不当会导致良性胆管狭窄.对于良性胆管狭窄的治疗目前有多种方法可供选择,本文主要介绍损伤性高位良性胆管狭窄的外科治疗策略.
Iatrogenic bile duct injuries （BDIs） andsubsequent benign biliary stricture is a medical catastrophe which is associated with significant perioperative morbidity and mortality, reduced long-term survival rate and poor quality of life. For most major BDIs （Strasberg classification E1-E4） , the recommended method of repair is hepaticojejunostomy （HJ）. We conducted a retrospective review aiming to examine the surgical technique of high HJ at our institution. This review highlights 4 aspects in the operation which include the hepatoduodehal ligament exposure, hepatic artery and its branches protection, exposing the intrahepatic bile duct above the stricture plane, and HJ techniques. Overall, the optimal long-term result of surgical management depends on the availability of experienced hepatobiliary surgeons and a considerable large HJ anastomosis above the stricture.
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2012年第5期408-410,共3页
Chinese Journal of Digestive Surgery
关键词
胆管狭窄
良性
胆管损伤
医源性
肝管空肠吻合术
Biliary stricture, benign
Bile duct injuries, iatrogenic
Hepaticojejunostomy
