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yi yuan xing dan guan sun shang 20 li lin chuang fen xi
Author(s): 
Pages: 9-10
Year: Issue:  4
Journal: THE MEDICAL JOURNAL OF INDUSTRIAL ENTERPRISE

Keyword:  医源性疾病胆管;
Abstract: 目的:探讨医源性胆管损伤的原因、治疗及预防.回顾分析了20例医源性胆管损伤的原因及处理.结果:医源性胆管损伤多发生于胆囊切除术,其中胆道解剖异常、局部病理因素、术中出血及麻醉欠佳、病人体型等为其客观因素:而本组人为因素非常明显,16例由高年资医师实施,过分自信、草率、盲目追求小切口有关.不同类型的胆管损伤应采取不同方法及早处理;术中发现者,可行裂口修补或端端吻合、T管支撑引流术,强调置管时间不少于6个月.对胆漏先行胆道及腹腔引流术,3个月后再作胆道重建术,手术方法以胆管空肠Roux-en-Y吻合最为理想.术后黄疸病例行胆管空肠Roux-en-Y吻合术,疗效佳.结论:提高医生对胆管损伤的警觉性,术中解剖清楚,操作细致,是预防医源性胆管损伤的关键.
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