摘要
目的 探讨医源性总胆管远段损伤的原因及诊断和治疗的措施。方法 对过去 1 1年中收治的总胆管探查致总胆管远段损伤 8例病人进行回顾性分析。结果 医源性总胆管远段损伤的原因主要与显露不好、操作不当有关 ,术中表现主要是注水试验阳性 ,胆道扩张器头异位于十二指肠腔外 ,胆道镜发现胆总管远段破口。术后表现主要是右上腹痛、腰背部抬举痛及上述三者之一。治疗主要作Oddi括约肌切开成形、长臂T管支撑。结论 胆总管远段损伤的及时诊断 。
Objective To investigate the reasons for iatrogenic trauma in the end part of common bile duct and summarize experience in its diagnosis and treatment. Methods A retrospective study was conducted on the clinical data of 8 patients with iatrogenic trauma in the end part of common bile duct caused by exploration of the common bile duct during the past 11 years in our hospital. Results Iatrogenic trauma in the end part of common bile duct was caused by bad exposure and wrong operation. The major findings in the operations were: 1) positive test of irrigating water;2) head of the bile duct explorer being out of the duodenum;3) the split in the end part of the common bile duct being found by the bile duct glass. The postoperative findings were pains in the right upper abdomen, the waist and back or lifting pains. The major surgical procedures were Oddi's sphincter incision and shaping and long limb T tube supporting. Conclusions For iatrogenic trauma in the end part of common bile duct, timely diagnosis and right Oddi's sphincter incision and shaping can result in good results.
出处
《中华肝胆外科杂志》
CAS
CSCD
2002年第8期472-474,共3页
Chinese Journal of Hepatobiliary Surgery
