CAJ | 학술논문

目的总结医源性胆管损伤的经验教训,探讨医源性胆管损伤的治疗与预防.方法对14例医源性胆管损伤患者的临床资料进行回顾性分析.结果14例医源性胆管损伤均由肝外胆管手术所致,其中完全横断 4例,部分撕裂5例,电钩烧伤2例,迷走胆管瘘2例,胆囊管残端瘘1例.13例患者术中发生胆管损伤,其中 3例立即行胆管重建,5例立即行胆管修复,5例行单纯引流;1例术中未发现胆管损伤,损伤后3 d 行胆管重建.本组死亡2例,病死率为14.3%,其余患者随访未见异常.结论胆管损伤多为医源性所致,围术期有较高的并发症发生率和病死率,严重影响患者的存活率和生活质量,目前预后不佳.
목적총결의원성담관손상적경험교훈,탐토의원성담관손상적치료여예방.방법대14례의원성담관손상환자적림상자료진행회고성분석.결과14례의원성담관손상균유간외담관수술소치,기중완전횡단 4례,부분시렬5례,전구소상2례,미주담관루2례,담낭관잔단루1례.13례환자술중발생담관손상,기중 3례립즉행담관중건,5례립즉행담관수복,5례행단순인류;1례술중미발현담관손상,손상후3 d 행담관중건.본조사망2례,병사솔위14.3%,기여환자수방미견이상.결론담관손상다위의원성소치,위술기유교고적병발증발생솔화병사솔,엄중영향환자적존활솔화생활질량,목전예후불가.
Objective To summarize the experiences and lessons from iatrogenic bile duct injury and discuss the treatment and prevention of iatrogenic bile duct injury. Methods The clinical records of 14 patients with iatrogenic bile duct injuries were studied retrospectively. Results The injuries of 14 cases were from extrahepatic bile duct operation. 4 cases were from transections, 5 cases lacerations, 2 cases were from burns, 2 cases from bile leaks and 1 cystic duct leak. In 13 patients, the injury was recognized during the operation, three of them the biliary tract was reconstructed, five of them the injury was repaired immediately and five of them were treated with simple subhepatic drainage. 1 patient with the bile duct injury was not found during the operation and the patient underwent reconstruction 3 days after the injury. 2 patients died, and other patients were followed up. The mortality rate was 14.3% . Conclusion Bile duct injury is an iatrogenic catastrophe with significant perioperative morbidity and mortality, which had bad effect on long-term survival and quality of life. The prognosis after bile duct injury remains very poor.