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[肝外伤中的胆管损伤]

[Bile duct lesions in liver trauma].

作者信息

Becker H, Markus P M

机构信息

Klinik für Allgemeinchirurgie, Georg-August-Universität Göttingen.

出版信息

Chirurg. 1994 Sep;65(9):766-74.

PMID:7995085
Abstract

Injuries of the biliary tract remain an important concomitant lesion following liver trauma. Intra- and extrahepatic bile duct injuries differ substantially in etiology and choice of surgical procedure. Intrahepatic bile duct injuries gain clinical relevance postoperatively following primary surgical liver treatment. Characteristic consequences of intrahepatic bile duct injuries are: infected necrosis, abscess, bilious fistula, bilhemia, hemobilia and biliary duct stricture. In contrast, concomitant organ or vessel injury are of primary importance in extrahepatic biliary duct injury. Lesions of the distal biliary duct, always associated with duodenal or pancreatic injury, remains a particular thrill in general surgery. The approach to surgical treatment in case of biliary duct injury and its consequences are outlined and discussed in detail.

摘要

胆道损伤仍然是肝外伤后一种重要的伴随性病变。肝内和肝外胆管损伤在病因和手术方式的选择上有很大差异。肝内胆管损伤在肝脏初次手术治疗后在术后具有临床相关性。肝内胆管损伤的典型后果包括:感染性坏死、脓肿、胆瘘、胆汁血症、胆道出血和胆管狭窄。相比之下,伴随器官或血管损伤在肝外胆管损伤中最为重要。远端胆管损伤总是与十二指肠或胰腺损伤相关,仍然是普通外科中一个特别棘手的问题。本文详细概述并讨论了胆管损伤及其后果的手术治疗方法。

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