Experiences in Treatment of 28 Cases of Bile Duct Injury Caused by Cholecystectomy
- VernacularTitle:胆囊切除术致胆管损伤28例治疗体会
- Author:
Jianjun SUN
;
Ruihao LU
;
Shaomin FAN
;
Gang LI
- Publication Type:Journal Article
- Keywords:
Cholecystectomy;
Iatrogenic;
Anastomosis
- From:
Journal of Kunming Medical University
2014;(2):105-107
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the causes and the consequences of iatrogenic bile duct injury as well as experiences in its diagnosis and treatment. Method The clinical data of 28 in-patients who suffered from bile duct injury followed by cholecystectomy during January 1995 to September 2011 were collected and retrospectively analyzed. Result Bile duct injuries were found and diagnosed in al 28 in-patients during the processes of reoperation. Different treatments were carried out. 8 cases with mild injury were treated by placing the abdominal cavity drainage. 6 cases with bile duct split were repaired and set up with T tube drainage. 4 cases were initially treated by bile-intestinal Roux-y anastomosis. 1 case received repair operation of bile-intestinal Roux-y anastomosis after the external drainage of bile. 9 cases were initially treated with end-end bile duct anastomosis and 7 of 9 cases with concurrent anastomotic stenosis were performed repairing re-operations twice or more than twice. Among 7 cases, 1 case was performed with the operation of umbilical vein flap repair while 6 cases were treated with bile-intestinal Roux-y anastomosis repair. All cases in this observation were followed up to two years after repairing surgery:2 patients died and the rest 26 patients recovered after treatment. Conclusions The initial repairing operation is critical for iatrogenic bile duct injury and bile-intestinal Roux-y anastomosis should be the first choice of therapy,and it should be operated by experienced surgeons.
