肝十二指肠韧带减张术在医源性胆管缺损中的临床应用研究
간십이지장인대감장술재의원성담관결손중적림상응용연구
The use of the hepatoduodenal ligament tension-reduced operation in iatrogenic bile duct injury
  • 万方数据
    中华肝胆外科杂志 중화간담외과잡지
    CHINESE JOURNAL OF HEPATOBILIARY SURGERY
    2011年 9期 749-751 ,共3页

    毛根军%吴晓康%龚道军%沈蔚%张家敏%俞世安%厉学民%许龙堂%郑樟栋%程文元%戴振华%楼丽霞

    모근군%오효강%공도군%침위%장가민%유세안%려학민%허룡당%정장동%정문원%대진화%루려하

    医源性%胆管损伤%无张力%新方法 醫源性%膽管損傷%無張力%新方法
    의원성%담관손상%무장력%신방법
    Iatrogenic%Bile duct injury%Without tension%Novel method
    目的 探讨胆管缺损较大的医源性胆管损伤病例采用肝十二指肠韧带减张术（简称减张术）的可行性和有效性。方法 笔者于2006年3月至2009年5月共收治胆管缺损较大的医源性胆管损伤患者6例，其中BismuthⅡ型5例，BismuthⅢ型1例。采用7号丝线缝合肝门板组织与十二指肠球部浆肌层并打结，将肝门部与十二指肠球部拉拢的方法，借以缩短肝十二指肠韧带，使缺损胆管两断端真正在无张力下行端端吻合术。结果 6例胆管损伤患者，经肝十二指肠韧带减张术均获痊愈，随访至今未见有并发症。结论肝十二指肠韧带减张术对胆管缺损较大的医源性胆管损伤的治疗效果确切，可作为一种新的理念和术式在临床上推广应用。
    목적 탐토담관결손교대적의원성담관손상병례채용간십이지장인대감장술（간칭감장술）적가행성화유효성。방법 필자우2006년3월지2009년5월공수치담관결손교대적의원성담관손상환자6례，기중BismuthⅡ형5례，BismuthⅢ형1례。채용7호사선봉합간문판조직여십이지장구부장기층병타결，장간문부여십이지장구부랍롱적방법，차이축단간십이지장인대，사결손담관량단단진정재무장력하행단단문합술。결과 6례담관손상환자，경간십이지장인대감장술균획전유，수방지금미견유병발증。결론간십이지장인대감장술대담관결손교대적의원성담관손상적치료효과학절，가작위일충신적이념화술식재림상상추엄응용。
    Objective To investigate the feasibility and efficacy of using the hepatoduodenal ligament tension-reduced operation (tension-reduced operation in short) for iatrogenic bile duct injury where the bile duct was severely defective. Methods Between March 2006 and May 2009, the authors treated 6 patients with iatrogenic bile duct injury (Bismuth type Ⅱ : 5 patients and type Ⅲ : 1 patient). A no. 7 black silk thread was used to hold the hilar plate tissues and the seromuscular layer of the bulbous part of the duodenum closer together and knots were tied. This method brought the porta hepatis and the duodenal bulb closer together and the hepatoduodenal ligament was shortened. An end to end anastomosis could then be made between the two broken ends of the defective bile duct without tension. Results Six patients suffered from bile duct injury and they recovered fully after the tensionreduced operation. There was no complication on follow-up. Conclusions The tension-reduced operation was efficacious in the treatment of iatrogenic bile duct injury. This technique should be popularized and more widely used.
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