胆道再次手术228例分析
Reoperation of the biliary tract:analysis of 228 cases
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摘要: 目的:探讨胆道再次手术的原因、临床特点和处理方法,总结胆道疾病再手术的经验。方法:对收治的228例胆道再手术病例的临床资料进行分析。结果:发现胆道再次手术的主要原因为胆道结石的残留和复发,占本组病例的74.1%;其次为胆道损伤、吻合口狭窄、漏诊肿瘤。再次手术治疗以合并肝叶切除、胆肠吻合(部分为皮下盲袢式)、T管引流为主。结论:胆道再手术以胆道疾病本身原因为主,亦有医源性因素,再手术前应充分准备,系统检查,全面分析,术中仔细探查,选择合理的手术方式,以避免胆道反复手术。Abstract: Objective:To investigate the cause,clinic character and treatment,and to summarize the experiences for dealing with the reoperation of biliary tract.Methods:The clinical data of 228 patients admitted to our hospital who underwent reoperation of biliary tract were retrospectively analyzed.Results:The main cause of the reoperation was the residual or recurrent stones in the biliary tract (about 74.1% of the patients).Other cause including injury of the biliary tract,anastomotic stoma stricture and miss-diagnosed tumor.The treatments included hepatectomy,biliary-intestinal anastomosis and T-tube drainage.Conclusions:Disorders of the biliary tract account for the high possibility of the reoperation.The medical errors can also lead to reoperation of the biliary tract.Thoroughly examinations and systematic analysis preoperatively,carefully exploration and choosing suitable methods during the operation will greatly reduce the repeated operations.