Hosch S B, Zornig C, Izbicki J R, Prenzel K L, Thonke F, Broelsch C E
Abteilung für Allgemeinchirurgie, Universitätskrankenhaus Hamburg-Eppendorf.
Zentralbl Chir. 1996;121(4):290-3.
The rate of iatrogenic bile duct lesions has raised up to 3.5% after the introduction of laparoscopic cholecystectomy. Lesions that can not be managed endoscopically require surgical intervention. In this study 12 patients that presented with iatrogenic bile duct lesions following laparoscopic cholecystectomy and underwent reconstructive surgery at our institution are included. In nine patients a hepaticojejunostomy was performed, whereas two patients underwent end-to-end anastomosis. In one patient the lesion was oversewn. There were no complications postoperatively. After a median follow-up of 24,5 months (SD +/- 8 months) all patients are without symptoms. However, in two patients a postoperative endoscopic stenting for 4 months was necessary for bouginage. Reconstructive surgery, mainly hepaticojejunostomy in bile duct lesions is a safe and efficacious treatment of endoscopic treatment failure.
腹腔镜胆囊切除术开展后，医源性胆管损伤发生率已升至3.5%。无法通过内镜处理的损伤需要手术干预。本研究纳入了12例在我院接受腹腔镜胆囊切除术后出现医源性胆管损伤并接受重建手术的患者。9例患者进行了肝空肠吻合术，2例患者进行了端端吻合术。1例患者的损伤进行了缝合。术后无并发症。中位随访24.5个月（标准差±8个月）后，所有患者均无症状。然而，2例患者术后需要进行4个月的内镜支架置入以行探条扩张术。重建手术，主要是胆管损伤时的肝空肠吻合术，是内镜治疗失败后的一种安全有效的治疗方法。
