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Clinical Analysis of Iatrogenic Bile Duct Injury

Author: LiaoQuanHui
Tutor: ChenYanLing
School: Fujian Medical
Course: Surgery
Keywords: Iatrogenic bile duct injury Genotyping of bile duct injury Diagnosis Reason Treatment Prevention
CLC: R657.4
Type: Master's thesis
Year: 2011
Downloads: 30
Quote: 0
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Abstract


Objective: To investigate how to reduce iatrogenic bile duct injury occurred and the reasons for parting , diagnosis , prevention and treatment . Methods: Retrospective analysis of clinical data of 19 cases of iatrogenic bile duct injury in our hospital in May 2005 -2011 in March . Results: cholecystectomy , common bile duct exploration is a common cause of iatrogenic bile duct injury . Three cases found in this group of patients , including laparoscopic cholecystectomy was found in 14 1 cases , common bile duct exploration found two cases of postoperative clinical and radiographic examination confirmed 16 cases of bile duct injury in laparoscopic cholecystectomy cases of gastric ulcer line distal subtotal gastrectomy found one cases , ERCP EST postoperative discovered one cases . Anatomic site of injury factors , lesion characteristics and control strategies , bile duct injury divided into three types , clinical type II the most common , accounting for 57.9% ( 11 / 19 ) . Select the appropriate procedure according to the type of injury , in which the bile duct jejunum Roux-en-Y anastomosis in 9 cases, the gallbladder bed vagus bile duct ligation surgery in 3 cases, 2 cases of cystic duct ligation surgery , bile duct anastomosis T-tube drainage peritoneal drainage cases , bile duct repair T tube drainage peritoneal drainage in two cases , duodenal perforation repair completely outside of common bile duct exploration of common bile duct T-tube drainage of bile drainage jejunostomy one cases , ERCP ENBD1 cases . Early surgery eight cases , seven cases of delayed operation , which early reoperation cases . Conclusion: Iatrogenic bile duct injury is common in the cholecystectomy , carefully identify the cystic duct and the common hepatic duct and common bile duct three anatomical relationship cholecystectomy in the prevention of iatrogenic bile duct injury . Timely and correctly handle the early detection of bile duct injury , and a good grasp of the timing of surgery and the bile duct injury parting select the appropriate surgical approach to strengthen the prevention of bile duct injury , and to avoid the occurrence of biliary strictures and other serious complications .

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CLC: > Medicine, health > Surgery > Of surgery > Abdominal surgery > Gallbladder, bile duct
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