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頁籤選單縮合
| 題 名 | Injury to the Extrahepatic Bile Duct following Cholecystectomy=膽囊切除術後肝外膽管損傷--六例報告 |
|---|---|
| 作 者 | 楊圳隆; 黃恩澤; 蔡尚達; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 26:6 民82.11-12 |
| 頁 次 | 頁2063-2068 |
| 分類號 | 416.247 |
| 關鍵詞 | 膽囊切除術; 肝外膽管損傷; Extrahepatic bile duct; Cholecystectomy; Iatrogenic injury; Roux-En-Y biliary jejunal anastomosis; |
| 語 文 | 英文(English) |
| 中文摘要 | 膽囊切除術傷及肝外膽管常導致病患長期受害,馬偕外科近十年內共經驗六例,分析其原因為膽囊發炎導致解剖位置不明確及手術醫生經驗不足。四例術中發現一段總膽管被切除,另二例因術後才出現症狀而診斷,治療方式包括直接修補,膽道空腸吻合導管置留以及再次手術前的檢查治療。對於不同程度的膽管損傷及病患的狀況,雖然手術的方式應有所選擇,但常常併發術後膽道夾窄及膽管炎,處置不易,因此預防膽管的損傷才是最重要的課題。 |
| 英文摘要 | Six cases of iatrogenic injury to the extrahepatic bile duct have been treated at this Hospital over the past 10 years. Factors predisposing to this injury included acute inflammation of the gall bladder with distorted tissue planes, and surgery done without proper supervision. In four patients, bile duct damage was detected during the intitial surgery; in two others, it was apparant only postoperatively. Various approaches to repair including direct anastomosis, Roux-en-Y hepaticojejunostomy and the use of stents are disclllssed, as well as patient's preparation for any required reoperation. Choice of surgical technique must be individualized, depending on the patient's clinical condition and the extent of damage to the duct. Despite careful repair, stenosis and cholangitis may still develop. Therefore, prevention of iatrogenic injury is extremely important. |
本系統中英文摘要資訊取自各篇刊載內容。