肝胆手术胆漏发生原因分析及治疗体会.docVIP

精品论文 参考文献 肝胆手术胆漏发生原因分析及治疗体会 周任 (玉林市第一人民医院肝胆外科 广西玉林 537000) 【摘要】目的：探讨肝胆手术胆漏的发生原因，总结治疗体会。方法：对我院2010年1月～2012年1月进行肝胆手术后发生胆漏的76例患者的临床资料进行回顾性分析，分析胆漏发生的原因，总结肝胆手术后胆漏的治疗方法及效果。结果：肝胆手术后发生胆漏的原因包括：胆管损伤14例，胆管结扎线脱落16例，创面渗漏22例，胆道梗阻18例；拔T管后胆漏6例。其处理方法包括：非手术治疗48例，48例患者中有39例行常规引流，同时给予预防感染并营养支持治疗，9例患者在将引流管拔出后，行B超引导下穿刺置管引流术，开始时可采用负压引流方式，当引流量减少时，在采用常压引流；手术治疗18例。76例患者经治疗后均痊愈，无并发症发生。结论：肝胆手术后发生胆漏的原因众多，应注意预防，一旦发生胆漏应根据患者的病情采取非手术治疗及手术治疗。 【关键词】肝胆手术 胆漏 原因 治疗 体会 【中图分类号】R619 【文献标识码】B 【文章编号】2095-1752（2013）02-0272-02 The analysis of bile leakage causes in hepatobiliary surgery and treatment experience 【Abstract】Objectives: To discuss the causes of bile leakage in hepatobiliary surgery and summarize the treatment experience. Method: Make retrospective analysis of 66 bile leakage patients clinical cases in our hospital during January,2010 and January,2012.And to discuss bile leakage causes, summarize the treatment method and effect of bile leakage after hepatobiliary surgery. Results: The causes included：14 cases of bile duct injury, 16 cases of falling off of bile duct ligation line, 22 cases of wound leakage, 18 biliary obstruction, and 6 cases of pulling the T bile leakage. The handling methods included: Nonoperative treatment 48 cases, 39 routine conventional drainage in 48 patients, and at the same time, giving the prevention of infection and nutrition support treatment. Nine patients applied pulling out the tube, and made puncture for drainage tube under the guidance of line B, at the beginning it used the negative pressure drainage way, when lead flow decrease, it used the ordinary pressure drainage; 18 cases of surgical treatment. 66 patients were recovered after therapy, and no complications. Conclusion: There are numerous of reasons which has caused bile leakage, and it shoud be paid more attention. Once the leakage happened, the nonoperative surgical should be applied according to patientrsquo;s condition. 【Key Words】 Hepatobiliary