医源性胆管损伤的严重后果.pdfVIP

• 793 • ·专家经验· 医源性胆管损伤的严重后果 高志清付由池刘正才 【摘要】 固的 探讨胆囊切除水中严重医源性胆管损伤的原因、处理方法、经验教训与预防对 策。方法 回顾性分析本院 1992 年 10 月至 2005 年 4 月共处用的 202 例医源性胆管损伤中 9 例 (4.45%)致严重后果者的|临床资料，以致死致残cmb草残废) ，处理棘手，引发医疗纠纷及税资院大，判 定为严最后果。结果 严重院源性胞管损伤中 5 例死亡;4 例为阴道残废，赔款或继续阪疗费用巨 大。结论 胆囊切除71生或HE!道探查水中注意规泡性、轻柔操作、认真细致、谨慎的作风、熟悉解剖等能 有效避免胆管损伤;胆管损伤后及时发现并处理效果良好;防篮子泊。 【关键词】 阳智损伤; 胆囊切除: 阻总管探查 Severe con能quence of iatrogenic bile duct injuriω GAO Zhiqing , FU Youchi , LIU Zhengcai. De户αrt ment of Hepatobiliary Surgery , Xijing Hosρital ， the Fourth Military Medical University , Xi an 710032 , P. R. Chinα 【At附tract】 0均ective 丁o explore the cause , management , experience and preventive measures for the severe iatrogenic bile duct injuríes. Meth叫s A retrospectíve study was conducted to ínvesti … 如te the operative procedure and postoperative outcome of 9 patients developed death or biliary disabili… ty after severe iatrogenic bile duct injuries from October 1992 to April 2005 in our hospíta l. Resulú咽 。f the 9 patients , 5 died and 4 had biliary disability. Th巳 4 patients with bílíary disability n伫仅led fur… ther management , res lIltíng in increase of medical cost. Conclusions Iatrogenic bile dllct injuries can be avoided ín cholecystectomy or bile dllct exploration by careflll operation ，的tandard procedur贮 and well understanding of anatomic strllcture. Immediate repair should be performed once it occurs. Pre vention of tbe bile dllct injuries is more important than its treatm巳nt. Key words Bile duct injury; Cholecystectomy; Exploration 我院于 1992 年 10 月至 2005 年 4 月收治医源 例 3 ，男， 56 岁， LC 致胆管横断伤，眼腆炎，第 5 性朋管损伤 181 例，院外会诊处理 21 例，共 202 例， 天再次手术，病人已处于休克状态，腹腔内吸出约