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Iatrogenic bile duct injury (IBDI) is a severe complication in general surgery, especially during laparos-eopic cholecystectomy. Many factors may cause IBDi, in which the conscientiousness, skill and experience of the surgeons play a more important role than the abnormal anatomy and patholo-gical changes of the patient. The Bismuth's classification, which originated from the era of open surgery, does not cover the whole spectrum of bile duct injuries. Strasberg's classification made a supplement by including other types of extrahepatie bile duct injuries. The variation of opportunities leads to different thera-peutic strategies. When the injuries are diagnosed intraopera-tively, a conversion to open surgery is the option of choice, and the prosthesis should be performed by a more experienced surgeon. If the bile duct injury is diagnosed in the early stage after operation, therapeutic principles are as follows: biliary peritonitis often required an emergency reoperation, while extra-peritoneal drainage is ta

作者:姜洪池;姜宪

来源:中华消化外科杂志 2009 年 8卷 6期

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作者:
姜洪池;姜宪
来源:
中华消化外科杂志 2009 年 8卷 6期
标签:
胆管损伤 医源性 治疗 Bile duct injury iatrogenic Therapy
Iatrogenic bile duct injury (IBDI) is a severe complication in general surgery, especially during laparos-eopic cholecystectomy. Many factors may cause IBDi, in which the conscientiousness, skill and experience of the surgeons play a more important role than the abnormal anatomy and patholo-gical changes of the patient. The Bismuth's classification, which originated from the era of open surgery, does not cover the whole spectrum of bile duct injuries. Strasberg's classification made a supplement by including other types of extrahepatie bile duct injuries. The variation of opportunities leads to different thera-peutic strategies. When the injuries are diagnosed intraopera-tively, a conversion to open surgery is the option of choice, and the prosthesis should be performed by a more experienced surgeon. If the bile duct injury is diagnosed in the early stage after operation, therapeutic principles are as follows: biliary peritonitis often required an emergency reoperation, while extra-peritoneal drainage is ta