Discuss The Common Causes And Analyse Complication And Surgical Options Of Biliary Tract Surgical Reoperation

Objective:Analyse the common causes of re-operation of biliary tract after operation of biliary tract, summarize the operation experience again and preventive measures, Provide guidance and help to clinical work.Methods:With retrospective analysis of clinical date of 183 second-time biliary tract surgery having been conducted in our hospital from Jan,2007 to December, 2014,as well as analysis of that of 102 third-time and more times biliary tract surgery of our hospital and Kunming Medical University the Second Affiliated Hospital. Through above means, we can analysis and conclude the reason for second-time or more times surgery and selection of surgery, postoperative complications and follow-up good rate.Results:A total of 77.6%(142/183) of patients who had recurrent or retained calculi received first reoperation, which was significantly higher than27.5%(28/102)of those who received second or multiple reoperations(X2=68.42, P<0.05). A total of 68.6%(70/102)of patients who had benign stenosis of bilioenteric anastomosis received multiple reoperations, which was significantly higher than 12.5%(23/183) than those who received first reoperation(X2=93.63, P<0.05). Of the 285 patients, 49 had complications. The incidence of complications of patients who receive first reoperation was 10.9%(20/183), which was significantly lower than 28.4%(29/102)of patients who received second or muhiple reoperations(X2=14.09, P<0.05). Due to bile duct residual or recurrent stones again operation operation way main has the exploration of biliary tract, biliary enteric anastomosis, hepatic lobe (segment) resection or combined with above surgery use of, the postoperative excellent and good rate was 95.8%. Bile duct or anastomotic stenosis again operation the main mode of operation for biliary enteric anastomosis after operation, the excellent and good rate was 91%.Conclusions:Residual bile duct stones as well as relapse are the main reason for second-time biliary tract surgery, Anastomotic stenosis is a main reason for third-time or more time biliary tract surgery.With the number of twice biliary tract surgery increases, the probability of complication will be higher than before. The method of surgery to conduct for treating residual bile duct stones as well as relapse includesLi-thotomy+T tube drainage, Biliary intestinal anastomosis and hepatolobectomy, during above methods, the second one is the main surgery for treating Anastomotic stenosis, the selection of surgery’s method depends on diseased region and character.