|本期目录/Table of Contents|

[1]刘绪舜,王 伟,王 峰,等.111例胆道非计划再手术体会[J].医学研究与战创伤救治(原医学研究生学报),2011,13(02):116-118.
 LIU Xu-shun,WANG Wei,WANG Feng,et al.Reflections on 111 cases of non-planned bile duct reoperation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2011,13(02):116-118.
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111例胆道非计划再手术体会()

《医学研究与战创伤救治》(原医学研究生学报)[ISSN:1672-271X/CN:32-1713/R]

卷:
第13卷
期数:
2011年02期
页码:
116-118
栏目:
出版日期:
2011-03-20

文章信息/Info

Title:
Reflections on 111 cases of non-planned bile duct reoperation
文章编号:
1672-271X(2011)02-0116-03
作者:
刘绪舜王 伟王 峰宗光全刘仁民徐奥博栾 洋
210002 江苏南京,解放军81医院普通外科
Author(s):
LIU Xu-shun WANG Wei WANG Feng ZONG Guang-quan LIU Ren-min XU Ao-boLUAN Yang
Department of General Surgery, 81 Hospital of PLA, Nanjing, Jiangsu 210002,China
关键词:
胆道再次手术原因预防
Keywords:
bile duct reoperation cause prevention
分类号:
R657.4
DOI:
-
文献标志码:
A
摘要:
目的 探讨胆道非计划再手术的原因、策略及手术要点。方法 对1996年2月至2009年4月111例胆道非计划再手术的临床资料进行回顾分析。结果 胆道非计划近期再手术的主要原因是医源性胆管损伤,共7例,占近期病例的63.6%;远期再手术的主要原因是胆管残余或复发结石,共66例,占远期病例的66.0%。远期组再手术方式以肝叶段切除合并胆肠吻合或T形管引流为主,共35例,占远期病例的35.0%。胆道再手术后并发症发生率为14.4%。结论 胆道非计划再手术既有胆道疾病本身原因,也有医源性因素。重视术前准备、术中仔细探查、选择合理手术方式是减少胆道再手术的重要因素。把握好胆道再手术的策略是再手术成功的关键。
Abstract:
Objective To analyze the causes, prevention and points on treatment of bile duct reoperation. Methods The clinical data of 111 cases of bile duct reoperation in 81 hospital of PLA from February, 1996 to April, 2009 were investigated. Results The main cause of reoperation was iatrogenic bile duct injury, which occurred in 63.6% of the recent group. The main cause of reoperation lies in remain or recrudesce gallstones in bile ducts, which occurred in 66.0% of the long term group. Main surgical treatments of bile duct reoperation include lobar or segmental resection (35.0%) with Roux-en-Y hepatic ojejunostomy or T-tube drainage. The complication rate of reoperation was 14.4%. Conclusion Non-planned bile duct reoperation is mainly caused not only by the bile duct diseases but also by iatrogenic factors. Therefore, to reduce reoperation in bile ducts requires attaching great importance to the latent danger of bile duct operation, sufficient pre-operation preparation, and careful observation during operation. The key factor for a successful reoperation is to grasp the bile duct reoperation strategy.

参考文献/References:

[1]陈孝平,陈 汉.肝胆外科学[M].北京:人民卫生出版社,2005:526-549.
[2]梁力建.努力避免非计划性的胆道再次手术[J].中国实用外科杂志,2006,26(3):161-162.
[3]中华医学会外科学分会胆道外科学组.胆管损伤的预防与治疗指南(2008版)[J].中华消化外科杂志,2008,7(4):260-266.
[4] 蔡秀军,李哲勇.腹腔镜胆囊切除术中胆道损伤的预防和治疗[J].肝胆外科杂志,2010,18(2):89-91.
[5]de Reuver PR, Busch OR, Rauws EA,et al.Long-term results of a primary end-to-end anastomosis in peroperative detected bile duct injury[J]. J Gastrointest Surg, 2007,11(3):296-302.
[6]赖佳明,梁力建,彭宝岗,等.胆道再次手术235例分析[J].中国实用外科杂志,2006,26(3):181-183.
[7]李德春.残余胆囊诊治的探讨[J].国际外科学杂志,2007,34(4):217-218.
[8]黄江生.术中应用胆道镜治疗肝内胆管结石[J].中国内镜杂志,2005,11(9):975-976.

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更新日期/Last Update: 2011-03-20