医源性总胆管远段损伤的术中诊治与预防.pdfVIP

·99· 史望亘￡里丛型壁查!!!!堡!旦蔓!!鲞笙!塑曼!也』婪!墼!!!i!i!壁墅!g!壁!!!!!!!!!!!∑!!：!!!垒!!：! ·论著· 医源性总胆管远段损伤的 术中诊治与预防 粱刚 吴金术 刘昌军 【摘要】 目的探讨医源性总胆管远段损伤的术中诊治及预防。方法 回顾性复习1990年 2月至2005年2月湖南省人民医院收治的22例医源性总胆管远段损伤的病例。结果取石钳入腹 膜腔(95．5％)。注水试验阳性(100％)。长臂T管支撑总胆管是有效的手段。全组18例获得随访， 平均20．8个月。效果满意。结论术中胆扩裸露征、注水试验是总胆管远段损伤的有效诊断手段。 遵循浅、通、撑、抑四字外科原则，可获满意效果。满意的术野显露是有效的预防措施。 【关键词】医源性总胆管远段损伤；诊断；治疗； 预防 of distalcommonbileduct L1．4NG Diagnosis，treatment，andpreventioniatrogenic iniury Gang，WU J in—shu，LIU ProvincialHos— Chang—jun．DepartmentofHepatobiliarySurgery，HunanPeoples 410005，P．R．China pital，Changsha author：LfU CorrespondingChang—jun，Email：Li“c^口行g歹“行712@163．com Toreviewthe andcausesof tothedistalchole· [Abstract]Objectivediagnosis iatrogenicinjury dochusat Thecasenotesofthe withbileductiniuriesthatweretreated operation．Method patients in from1990．2—2005．2werereviewed．ResultsTodetectdistalbileduct myDepartment injuries，a soundinthebileducthadan rateof95％while ofwaterintothebileducttodetect accuracy injection a arm．T in ductwasaneffec— hadan rateof tubethecommonbile leakageaccuracy100％．Usinglong tivemethodtotreatthe 18 withan timeof20．8 re— injury．Inpatients averagefollow—up months，the were waterintothebileduetto distalcommonbile suits satisfactory．ConclusionsInjecting diagnose duet at wasaneffectivetodetectdistalbileduct ofthe injuryoperation way injury．Adequateexposure fieldisthebestmethodto bileduct operative prevent injury．