Diagnosis And Treatment Of Iatrogenic Bile Duct Injury

Objective: To explore the common causes of bile duct injury caused by laparoscopic surgery,and the method of clinical diagnosis and further treatment.Methods: By reading the literature,combined with nearly five years of my department were 17 cases of biliary injury caused by abdominal surgery patients.And according to the type of damage found time,damage,injury parts,diagnostic methods,respectively take different repair methods and the final recovery under the review analysis.Results: In the study of 17 cases,6 cases of male and female in 11 cases,minimum age 33 years old,biggest 75 years old,male and female ratio of 1:1.66,the average age of 55.17 cases of bile duct injury in accordance with Strasberg parting parting method,in which 2 cases for LC surgery found in vagus single pipe damage,both to intraoperative suture repair,2 cases of intraoperative found golden yellow bile from the damaged bile duct leakage,to the repair of bile duct + T tube support,14 cases were found during hospitalization,line including 3 cases with bile duct end to end anastomosis + T tube support,9 underwent biliary jejunum roux en-y suture,1 case after abdominal cavity drainage tube after conservative therapy,the symptoms improved healing.All the operations performed by the senior surgeon of hepatobiliary surgery,treatment during hospitalization were completed by the help of senior medical department of hepatobiliary surgery doctor.Postoperative follow-up process,except for 1 case lost to follow-up,1 case death,the rest of the cases were followed up.The death casescaused bycholestasis liver cirrhosis and multiple liver abscess to liver failure and death.Biliary stricture occurred in 3 cases after operation,all secondary bile duct jejunum roux-en-y operation.Conclusion:1.careful intraoperative identification of the three anatomical relationship is the key,Otherwise in case of bile duct injury,will bring great pain to the patient,affects the quality of life of patients,and may bring unnecessary medical disputes to the medical staff.2.IBDI once occurred,should be timely treatment,and use the right way,to reduce the occurrence of complications,in the same time,maximum avoid secondary operation.3.The most commonly method for the treatment of bile duct injury in clinic is the common bile duct jejunum Roux-en-Y anastomosis,However,the specific surgical approach should be based on the type of injury,location and timing of treatment.4.During the first operation,the patient was in good condition and the operation was the best.The more times of operation,the worse the systemic and local factors,the worse the effect.