摘要
目的 探讨合并有右肝管缺如者行胆囊切除术时易致医源性胆道损伤的危险因素及防治方法。方法对我院1990年3月至2002年4月收治的18例合并有右肝管缺如行胆囊切除术所致的医源性胆道损伤进行回顾性分析。结果损伤原因主要是将右肝后叶胆管误认为胆囊管而一并切除。损伤部位以Ⅱ类多见。结论对右肝管缺如胆道异常解剖结构的认识及胆囊切除前遵循“辨一切一辨”三字原则是预防医源性胆道损伤的关键,而损伤后诊断时期与损伤类型决定了外科手术方式的正确选择。
Objective To investigate the risk factors and methods for prevention and treatment of iatrogenic bile duct injury caused by cholecystectomy in patients with complication of right hepatic duct defect. Methods The clinical data of 18 patients treated in our hospital from March 1990 to April 2002 were retrospectively analyzed. All these patients with the complication of right hepatic duct defect were suffering from iatrogenic bile duct injury during cholecystectomy. Results The bile duct in the right posterior lobe was wrongly regarded as cystic duct and the resection was the major reason for its injury. The major injury type was class Ⅱ. Conclusions To realize the abnormal bile duct anatomy such as right hepatic duct defect and obey the principle of ' identification-cut-identification' during cholecystectomy is important for prevention of iatrogenic bile duct injury. The selection of operation should be decided by the injury type and period of diagnosis after the injury.
出处
《中华肝胆外科杂志》
CAS
CSCD
2003年第12期733-735,共3页
Chinese Journal of Hepatobiliary Surgery
