Clinical Analysis Of Iatrogenic Bile Duct Injury

Objective: To explore how to reduce the occurrence of iatrogenic bile duct injury and to investigate its etiology,classification,diagnosis,prevention and management.Methods: A retrospective review was undertaken of 19 patients with iatrogenic bile duct injury who presented to our institution from May 2005 to March 2011.Results: Cholecystectomy, exploratory choledochotomy is a common cause of iatrogenic bile duct injury. Intraoperative found 3 cases, 1 patient was found in laparoscopic cholecystectomy, 2 patients were found in exploratory choledochotomy; 16 patients were confirmed by postoperative clinical and imaging examination, 14 cases after laparoscopic cholecystectomy, 1 case do distal stomach ulcer, found that most after resection in , 1 case ERCP +EST postoperative found. According to the anatomical site, causes, pathological characters, prevention and treatment of bile duct injury, iatrogenic bile duct injury is proposed three types. Of the 19 patients, 5 were type-I,11 were type-II,3 were type-III. The mode of surgery:9 patients were Biliary jejunal Roux - en - Y anastomosis;3patients were Gallbladder bed intraoperative vagus bile duct seam;2 patients were ductuscysticus seam;1 patient was end-to-end bile duct reconstruction and abdominal drainage and T-tube draining;2patients were bile duct repair and abdominal drainage and T-tube draining;1patient was duodenal perforation repair and bravery manager of bravery manager probe and T-tube drainage and bile drainage and jejunum entirely outside colostomy art;1 patient was ERCP and ENBD. 8 procedures were performed primarily in early stage, 7 procedures were performed primarily in late stage, and 1 procedure was performed secondarily. Conclusions: Iatrogenic bile duct injury commonly occur in Cholecystectomy. It is the key to prevent iatrogenic bile duct injury in cholecystectomy by carefully identifying cystic duct and liver duct and bravery manager anatomic relationship. It is most crucial to avoid bile duct stricture and other serious complication by early detection and correcting prompt processing, grasping the correct treatment of bile duct injury, according to different classification of bile duct injury to choose the appropriate operation method, and strengthening the prevention of bile duct injury.