摘要
目的 了解我国当前对医源性胆管损伤外科治疗概况及胆管损伤治疗效果。方法 通过检索解放军医学图书馆中文生物医学期刊数据库 (CMCC)从 1995年 1月至 2 0 0 0年 1月全国各级期刊关于胆管损伤的论文 ,统计来自 16 5个医疗单位 2 742例医源性胆管损伤。结果 统计显示胆管损伤的 94%来自与胆囊有关的手术 ,以胆管横断伤为多 (4 7%) ,损伤类型主要为胆总管 (4 4%)和肝总管 (36 %) ,有 40 %为术中及时发现处理 ,胆管损伤修复手术因狭窄再手术占总数的 2 3 %,术中发现和术后发现及胆管修复的方式有明显的差异。结论 胆管损伤后期的修复防止狭窄是较困难的 ,调查修复方式显示术中发现的作胆管修补 +T管支撑引流 ,术后发现手术作胆管空肠吻合 +长期支撑的手术方式效果较好。
Objective To investigate the general feature of pathogenic bile duct injury and the effect of surgical treatment in China.Methods Review all Chinese articles about bile duct injury from 1995.1 to 2000.1 through Chinese Medical Current Contents(CMCC)of the Medical Library of PLA.Totally 2742 cases of bile duct injury from 165 medical units were analyzed.Results The statistics showed 94% bile duct injury resulting from operations was related to cholecystectomy.About 40% of the injuries was found at operations.Reoperation after primary bile duct repair was 23% in the whole series,the result of operation was different,whether the injury was recognized during operation and repaired immediately or it was found after the operation.Conclusion It is difficult to have a good result when the repair was delayed.Better effect result may be obtained in cases treated by bile duct repair with T tube during the primary operation,and cholangiojejunostomy with stent is better when repair is delayed.
出处
《中国实用外科杂志》
CSCD
北大核心
2001年第7期413-414,共2页
Chinese Journal of Practical Surgery
