Abstract:

More attention should be paid to the problems in the diagnosis and treatment of iatrogenic bile duct injury                QUAN Zhi-wei, WANG Jian-dong. Department of General Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，Shanghai 200090，China Corresponding author：QUAN Zhi-wei，E-mail：zhiwquan@163.com
Abstract    Iatrogenic bile duct injury is still one of the difficulties and hotspots in biliary surgery，because of its high incidence，disability and mortality. At the same time，iatrogenic bile duct injury is a kind of disease with "human factors" as the main cause. It is possible to reduce its occurrence，change its malignant outcome and benefit patients through the efforts of surgeons. Every abdominal surgeon will face the risk of bile duct injury in the whole time. So everybody must be vigilant，subjective familiar with the possible causes of bile duct injury，bile duct injury prevention and reasonable selection of the treatment method of bile duct injury.    Attention should be paid to the delayed injury and long-term curative effect of bile duct injury and the guiding significance of iatrogenic bile duct injury classification in clinical treatment should be re-recognized. Surgeons must not perform surgery as their own wishes to avoid catastrophic consequences. Adhering to the policy of "prevention first，timely detection，reasonable treatment and protecting function"，the therapeutic effect of iatrogenic bile duct injury in China will be effectively improved.

Key words: iatrogenic bile duct injury, classification, timing of repair

摘要：

目前，医源性胆管损伤仍然是胆道外科的难点与热点之一，原因在于其居高不下的发生率及致残、致死率。同时，医源性胆管损伤又是一种“人为因素”为主要病因的疾病，通过外科医生的努力有可能减少其发生，改变其恶性结局，造福病人。每位腹部外科医生终身都将面临胆管损伤的风险，必须主观上提高警惕，熟悉胆管损伤的可能原因，了解胆管损伤的预防方法，合理选择胆管损伤的治疗方法，重视胆管损伤的延迟性损害及远期疗效，重新认识医源性胆管损伤分型对临床治疗的指导意义，切不可随心所欲地手术，以免造成灾难性后果。坚持“预防为主、及时发现、合理治疗、保护功能”的原则，切实提高我国医源性胆管损伤的治疗效果。

关键词: 医源性胆管损伤, 分型, 手术时机