Tret'iakov A A, Slepykh N I, Kornilov A K, Karimov Z Kh
Khirurgiia (Mosk). 1998(10):46-50.
The analysis of 70 cases of surgical treatment for intraoperative injuries and cicatricial strictures of extrahepatic bile ducts was carried out. In 25 patients surgical procedure was restorative and in 45--reconstructiver. Most common causes of corrective operations were: iatrogenic injuries of extrahepatic bile ducts (14) and cicatricial strictures of hepaticocholedochal duct due to intraoperative trauma (31). The problems of operative technique in performing biliobilio-, hepato-hepatico and hepatico-jejuno-anastomoses are considered. There were three deaths in the early postoperative period: 2 patients died of hepatic failure, pyogenic cholangiogenic intoxication caused by cholangioectasies and intrahepatic abscesses, and 1-due to generalyzed peritonitis caused by acute gastric ulcer perforation. Special attention is paid to the choice of the method of prolonged drainage used in reconstructive as well as in restorative operations.
对70例肝外胆管术中损伤及瘢痕性狭窄的手术治疗进行了分析。25例患者接受了修复性手术，45例接受了重建性手术。矫正手术最常见的原因是：肝外胆管医源性损伤（14例）和肝门胆管因术中创伤导致的瘢痕性狭窄（31例）。讨论了进行胆胆吻合、肝肝吻合和肝空肠吻合时的手术技术问题。术后早期有3例死亡：2例死于肝功能衰竭、胆管扩张和肝内脓肿引起的化脓性胆管源性中毒，1例死于急性胃溃疡穿孔引起的弥漫性腹膜炎。特别关注重建性手术和修复性手术中延长引流方法的选择。
