Ampullary bile duct exploration in the Causes and Prevention of Injury.docVIP

 PAGE \* MERGEFORMAT 7 Ampullary bile duct exploration in the Causes and Prevention of Injury [Keywords:] ampullary injury [Keywords:] bile duct exploration; ampulla injury; Control A clinical data 199805/200408 diagnosis and treatment of bile duct exploration were caused by ampullary injury in 10 cases (including 2 cases transferred to other hospitals), 7 males and 3 females; aged 43 to 72 years old, are cholelithiasis line common bile duct exploration. 10 cases of emergency surgery in 8 cases of elective surgery in 2 cases. The first operation in 7 cases, re-or multiple upper abdominal surgery in 3 patients. injury areas: the posterior wall of descending duodenum in 5 cases, the anterior wall of descending duodenum in 2 cases, Vater ampulla 2 cases, the end of common bile duct in 1 case. surgery in the early detection of injury in 4 cases, of which 3 cases were common bile duct exploration when the metal probe of the lower end of common bile duct or ampulla-induced damage, OK Oddi sphincterotomy forming, common bile duct end / ampulla repair, common bile duct T-tube drainage after peritoneal catheter drainage; the other one cases of descending duodenal diverticulum perforation, OK diverticulum resection, duodenal descending repair, common bile duct T tube drainage and drainage after the peritoneal catheter and gastric tube leading to the descending duodenum. Following the above treatment, 5 patients had no complications, and soon discharged. surgery is not timely detection of damage in 3 cases. 1 after 3 d was found in cases of peritoneal drainage for the digestion of oral methylene blue liquid discharged from the peritoneal drainage tube due to a small fistula, drainage unobstructed, by conservative treatment and 45 d fistula healing. The other three cases of appendiceal abscess after operation, respectively, pancreatitis and retroperitoneal infection and necrosis, intra-abdominal bleeding, biliary fistula, wound dehiscence after repeated (n = 2 to 3 tim