关键词: 医源性胆管损伤, 修复, 胆管对端吻合, 胆肠吻合

Abstract:

Selection and evaluation of primary repair of iatrogenic bile duct injury        CHENG Qing-bao, LIU Chen, JIANG Xiao-qing. No.1 Department of Biliary Surgery， Eastern Hepatobiliary Surgery Hospital，the Second Military Medical University, Shanghai 200438, China
Corresponding author: JIANG Xiao-qing,E-mail:jxqehbh@sina.com
Abstract    With the gradual development and popularization of laparoscopic and robotic surgery, the incidence of iatrogenic bile duct injury is increasing gradually. Surgery is still the most effective way to treat severe bile duct injury. However, there is still a great deal of disputes about the choice of timing of surgery and the choice of repair methods. After finding the bile duct injury, the local and systemic condition of the injury should be evaluated in detail by the specialist with the corresponding technical condition, and the injury should be repaired earlier as far as possible, because of the trauma is relatively small, and the doctors and patients are relatively easy to accept. The purpose of surgical repair is to restore the continuity of the biliary tract, taking into account that most of the lesions are transverse injury, and the repair methods mainly include choledochojejunostomy and bile duct end-to-end anastomosis, according to the local and systemic conditions of the injury, as well as the experience and technical choice of the surgeon. Iatrogenic bile duct injury is still a difficult problem in bile duct surgery at present. The emphasis should be on prevention. It is very important to evaluate it in detail before operation and make sure whether there is anatomic variation of bile duct injury by MRCP. Careful operation should be carried out during the operation to avoid biliary tract injury.

Key words: iatrogenic bile duct injury, repair, bile duct end-to-end anastomosis, choledochojejunostomy