Sulkowski U, Brockmann J, Dinse P
Klinik für Allgemeine Chirurgie, Westfälische Wilhelms-Universität, Münster.
Langenbecks Arch Chir. 1996;381(5):246-50. doi: 10.1007/BF00184044.
From 1990 to 1995, 27 patients with biliary injuries were treated at the Department of General Surgery of Münster University Hospitals. All lesions occurred during cholecystectomy, either via laparoscopy (n = 17) or via laparotomy (n = 10). Ten patients were male and 17 female. The mean age was 51.2 years. In all cases a preoperative ERCP was performed. Based on the ERCP status a new classification was developed taking into account the type and location of the injury, as well as the opportunity for endoscopic treatment. Twenty-two patients underwent surgical bile duct reconstructions (12 hepaticojejunostomies, 3 choledochojejunostomies, 7 direct reconstructions). In five cases endoscopic therapy alone was successful. The perioperative mortality was 7.4% (2/27). Three of the surviving 25 had to be readmitted for recurrent cholangitis. Only 15 feel well without any limitations on everyday activities.
1990年至1995年期间，明斯特大学医院普通外科治疗了27例胆管损伤患者。所有损伤均发生在胆囊切除术期间，其中17例通过腹腔镜手术，10例通过开腹手术。10例为男性，17例为女性。平均年龄为51.2岁。所有病例术前均进行了内镜逆行胰胆管造影（ERCP）。根据ERCP结果，制定了一种新的分类方法，该方法考虑了损伤的类型和位置以及内镜治疗的机会。22例患者接受了胆管重建手术（12例肝空肠吻合术、3例胆总管空肠吻合术、7例直接重建术）。5例仅通过内镜治疗即获成功。围手术期死亡率为7.4%（2/27）。25例存活患者中有3例因复发性胆管炎再次入院。只有15例患者感觉良好，日常活动无任何限制。
