Helmy Mohamed A
Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt.
J Egypt Soc Parasitol. 2008 Dec;38(3):873-82.
The bile duct injuries rose from 0.1%-0.2% to 0.4%-0.7% from the era of open cholecystectomy to the era of laparoscopic cholecystectomy. Many classifications categorized the biliary tract injury, but none was universally accepted. In this study, 10 patients with iatrogenic major bile duct injuries were managed in Al Rahba General Hospital, UAE (April 2003 to December 2007). They were 8 females & 2 males with a mean age of 46.5 years and a mean hospital stay of 19.4 days. Four patients were initially operated upon for laparoscopic cholecystectomy and six were initially operated on elsewhere. Intraoperative bile duct injury was discovered in only 2 cases, and in 8 patients, bile duct injury was discovered in the postoperative period. Roux en Y hepaticojejunostomy was the treatment of choice for 6 patients, and 4 patients was choledochodudenostomy in one patient, left hepaticojejunostomy in another, end to end anastomosis of common bile duct over a T tube in a third patient, and removal of a clip in the last patient. There was no mortality, but in the first year postoperative follow up, 2 developed cholangitis which responded to antibiotic.
从开放胆囊切除术时代到腹腔镜胆囊切除术时代，胆管损伤率从0.1%-0.2%上升至0.4%-0.7%。许多分类方法对胆道损伤进行了分类，但没有一种被普遍接受。在本研究中，阿联酋拉赫巴综合医院（2003年4月至2007年12月）收治了10例医源性主要胆管损伤患者。其中女性8例，男性2例，平均年龄46.5岁，平均住院时间19.4天。4例患者最初接受腹腔镜胆囊切除术，6例患者最初在其他地方接受手术。仅2例术中发现胆管损伤，8例患者在术后发现胆管损伤。6例患者的治疗选择是Roux-en-Y肝空肠吻合术，1例患者行胆总管十二指肠吻合术，1例患者行左肝空肠吻合术，第3例患者在T管支撑下行胆总管端端吻合术，最后1例患者取出夹子。无死亡病例，但术后第一年随访时，2例发生胆管炎，经抗生素治疗有效。
