Advances in Clinical Diagnosis and Treatment of Iatrogenic Bile Duct Injury_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 KOUGui-xiang ¹ ,  ChAIChen ²

1. Clinical Teaching and Research Section, Health Vocational College of Gansu Province, Lanzhou 730000, Gansu Province, China;
2. Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, Gansu Province, China;

Corresponding?author：

ChAIChen, Email: chasechai@126.com

Keywords：

Iatrogenic bile duct injury; Diagnosis; Treatment; Prevetion; Review literature

DOI：

10.7507/1007-9424.20140317

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the cause, clinical diagnosis and treatment, and prevention strategies of iatrogenic bile duct injury (IBDI). Methods By means of literature retrieval, the clinical diagnosis and treatment measures of patients with IBDI were summarized. Results The related risk factors of IBDI include man-made factors, the local anatomy variation factors, and pathological factors. According to the damage diagnosis time and local pathological state, the repair operations such as bile duct suture repair, biliary tract end to end anastomosis, bile duct jejunum Roux-en-Y anastomosis, bile duct jejunum Roux-en-Y anastomosis, and jejunal artificial valve forming, or liver resection, and liver transplantation were performed. Moreover, it was also available that biliary stent or papillary balloon dilation through ERCP for the bile duct distal stricture. Conclusions It is important that prevention of IBDI. Operation should pay attention to upper abdominal operation prior to the implementation of the correct understanding of IBDI. In case of IBDI, the reasonable repair operation mode should be choose according to the damage types and time, and it can significantly improve the treatment effect and quality of life of patients.

Citation： KOUGui-xiang, ChAIChen. Advances in Clinical Diagnosis and Treatment of Iatrogenic Bile Duct Injury. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1321-1324. doi: 10.7507/1007-9424.20140317 Copy

1.	Tantia O, Jain M, Khanna S, et al. Iatrogenic biliary injury:13305 cholecystectomies experienced by a single surgical team over more than 13 years[J]. Surg Endosc, 2008, 22(4):1077-1086.
2.	T?rnqvist B, Str?mberg C, Presson G, et al. Effect of intended intraoperative cholangiography and early detection of bile duct injury on survival aftercholecystectomy:population based cohort study[J]. BMJ, 2012, 345):e6457.
3.	秦樂運.沖吸鈍性解剖法防止腹腔鏡膽囊切除術中膽道損傷的應用心得[J].中國中西醫結合外科雜志, 2013, 19(2):203-204.
4.	中華醫學會外科學分會膽道外科學組.膽管損傷的診斷與治療指南(2013版)[J].中華消化外科雜志, 2013, 12(2):81-95.
5.	郭蓋章.腹腔鏡膽囊切除術并發癥28例教訓分析[J].肝膽外科雜志, 2009, 17(6):451-452.
6.	黃志強.醫源性膽管狹窄:膽道外科之痛[J].中華消化外科雜志, 2008, 7(1):1-5.
7.	陸秀澤.醫源性膽管損傷中機械性損傷與熱力損傷的臨床治療觀察[J].中國醫療前沿, 2013, 8(10):37, 42.
8.	李良, 魯俊, 張軍, 等.腹腔鏡膽總管切開取石在老年膽道結石患者中的應用[J].中華全科醫學, 2011, 9(7):1037-1039.
9.	方金滿, 潘文, 許先軍, 等.膽囊切除相關性膽道損傷的診治分析[J].肝膽外科雜志, 2013, 21(1):48-50.
10.	劉金鋼.腹腔鏡膽囊切除術中醫源性膽管損傷的預防[J].中國實用外科雜志, 2011, 31(7):571-573.
11.	劉剛峰.膽囊切除術中膽道損傷的預防[J].中國臨床研究, 2013, 26(6):581-582.
12.	劉群, 郭琪, 梁曉燕, 等.膽囊管正常變異的X線分析及臨床意義[J].實用放射學雜志, 2002, 18(1):20-22.
13.	汪麗偉. 31例醫源性膽管損傷診療體會[J].中國傷殘醫學, 2013, 21(4):111-112.
14.	袁德汗, 陳應軍, 衛洪波, 等.腹腔鏡膽囊切除術所致膽道損傷的相關危險因素分析[J].中國內鏡雜志, 2013, 19(5):492-495.
15.	林擎天.醫源性膽管損傷的診治[J].肝膽胰外科雜志, 2012, 24(1):5-7.
16.	羅昆侖, 方征, 董志濤, 等.腹腔鏡下膽囊三角區結構變異的認識與處理[J].中國微創外科雜志, 2009, 9(8):720-721.
17.	Wu YV, Linehan DC. Bile duct injuries in the era of laparoscopic cholecystectomies[J]. Surg Clin North Am, 2010, 90(4):787-802.
18.	de Reuver PR, Rauws EA, Brumo MJ, et al. Survival in bile duct injury patients after laparoscopic cholecystectomy:a multi-disciplinary approach of gastroenterologists, radiologists, and surgeons[J]. Surgery, 2007, 142(1):1-9.
19.	de Reuver PR, Grossmann I, Busch OR, et al. Referral pattern and t iming of repair are risk factors for complications after recons-tructive surgery for bile duct injury[J]. Ann Surg, 2007, 245(5):763-770.
20.	Sikora SS, Pottakkat B, Srikanth G, et al. Postcholecystectomy benign biliary strictures-long-term results[J]. Dig Surg, 2006, 23(5-6):304-312.
21.	張永杰.感染性膽道損傷的再手術治療[J].中國實用外科雜志, 2006, 26(3):173-176.
22.	Thomson BN, Parks RW, Madhavan KK, et al. Early specialist repair of biliary injury[J]. Br J Surg, 2006, 93(2):216-220.
23.	董家鴻.醫源性膽道損傷及損傷性膽管狹窄的現代外科處理[J].中華消化外科雜志, 2008, 7(1):6-8.
24.	姜洪池, 高越.醫源性膽道損傷的不可忽視性及其防治策略[J].中華肝膽外科雜志, 2005, 11(3):152-154.
25.	楊堅, 苗雄鷹, 陳湘平, 等. 49例腹腔鏡膽囊切除術所致醫源性膽管損傷的處理[J].中國現代手術學雜志, 2013, 17(3):181-183.
26.	張永杰.如何掌握膽管損傷后再手術時間[J].肝膽外科雜志, 2004, 12(3):166-168.
27.	黃強, 劉臣海, 王成, 等.梗阻性膽道損傷修復時機的實驗研究[J].實用醫學雜志, 2011, 27(3):389-391.
28.	Slater K, Strong RW, Wall DR, et al. Iatrogenic bile duct injury:the sourage of laparoscopic cholecystectomy[J]. ANZ J Surg, 2002, 72(2):83-88.
29.	李徽, 李全輝, 陳雨信.膽道空腸Roux-en-Y吻合術[J].中華現代外科學雜志, 2008, 5(8):591-592.
30.	范愛國, 張富, 楊國興.空腸人工瓣膜成形在膽道Roux-en-Y吻合術中的應用[J].中國現代普通外科進展, 2011, 14(7):566-567.
31.	郭永生, 張衛東.特殊術后病人的介入輔助治療3例[J].現代保健:醫學創新研究, 2007, 4(36):45-46.
32.	谷化劍, 馮賢松, 辛小燕.醫源性膽道損傷的原因分析與防治策略[J].中國普通外科雜志, 2013, 22(2):192-196.
33.	Ardiles V, MeCormack L, Qui?onez E, et al. Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina:results from a National Survey[J]. HPB(Oxford), 2011, 13(8):544-550.
34.	Vitale GC, Tran TC, Davis BR, et al. Endoscopic management of postcholecystectomy bile duct strictures[J]. J Am Coll Surg, 2008, 206(5):918-923.

1. Tantia O, Jain M, Khanna S, et al. Iatrogenic biliary injury:13305 cholecystectomies experienced by a single surgical team over more than 13 years[J]. Surg Endosc, 2008, 22(4):1077-1086.
2. T?rnqvist B, Str?mberg C, Presson G, et al. Effect of intended intraoperative cholangiography and early detection of bile duct injury on survival aftercholecystectomy:population based cohort study[J]. BMJ, 2012, 345):e6457.
3. 秦樂運.沖吸鈍性解剖法防止腹腔鏡膽囊切除術中膽道損傷的應用心得[J].中國中西醫結合外科雜志, 2013, 19(2):203-204.
4. 中華醫學會外科學分會膽道外科學組.膽管損傷的診斷與治療指南(2013版)[J].中華消化外科雜志, 2013, 12(2):81-95.
5. 郭蓋章.腹腔鏡膽囊切除術并發癥28例教訓分析[J].肝膽外科雜志, 2009, 17(6):451-452.
6. 黃志強.醫源性膽管狹窄:膽道外科之痛[J].中華消化外科雜志, 2008, 7(1):1-5.
7. 陸秀澤.醫源性膽管損傷中機械性損傷與熱力損傷的臨床治療觀察[J].中國醫療前沿, 2013, 8(10):37, 42.
8. 李良, 魯俊, 張軍, 等.腹腔鏡膽總管切開取石在老年膽道結石患者中的應用[J].中華全科醫學, 2011, 9(7):1037-1039.
9. 方金滿, 潘文, 許先軍, 等.膽囊切除相關性膽道損傷的診治分析[J].肝膽外科雜志, 2013, 21(1):48-50.
10. 劉金鋼.腹腔鏡膽囊切除術中醫源性膽管損傷的預防[J].中國實用外科雜志, 2011, 31(7):571-573.
11. 劉剛峰.膽囊切除術中膽道損傷的預防[J].中國臨床研究, 2013, 26(6):581-582.
12. 劉群, 郭琪, 梁曉燕, 等.膽囊管正常變異的X線分析及臨床意義[J].實用放射學雜志, 2002, 18(1):20-22.
13. 汪麗偉. 31例醫源性膽管損傷診療體會[J].中國傷殘醫學, 2013, 21(4):111-112.
14. 袁德汗, 陳應軍, 衛洪波, 等.腹腔鏡膽囊切除術所致膽道損傷的相關危險因素分析[J].中國內鏡雜志, 2013, 19(5):492-495.
15. 林擎天.醫源性膽管損傷的診治[J].肝膽胰外科雜志, 2012, 24(1):5-7.
16. 羅昆侖, 方征, 董志濤, 等.腹腔鏡下膽囊三角區結構變異的認識與處理[J].中國微創外科雜志, 2009, 9(8):720-721.
17. Wu YV, Linehan DC. Bile duct injuries in the era of laparoscopic cholecystectomies[J]. Surg Clin North Am, 2010, 90(4):787-802.
18. de Reuver PR, Rauws EA, Brumo MJ, et al. Survival in bile duct injury patients after laparoscopic cholecystectomy:a multi-disciplinary approach of gastroenterologists, radiologists, and surgeons[J]. Surgery, 2007, 142(1):1-9.
19. de Reuver PR, Grossmann I, Busch OR, et al. Referral pattern and t iming of repair are risk factors for complications after recons-tructive surgery for bile duct injury[J]. Ann Surg, 2007, 245(5):763-770.
20. Sikora SS, Pottakkat B, Srikanth G, et al. Postcholecystectomy benign biliary strictures-long-term results[J]. Dig Surg, 2006, 23(5-6):304-312.
21. 張永杰.感染性膽道損傷的再手術治療[J].中國實用外科雜志, 2006, 26(3):173-176.
22. Thomson BN, Parks RW, Madhavan KK, et al. Early specialist repair of biliary injury[J]. Br J Surg, 2006, 93(2):216-220.
23. 董家鴻.醫源性膽道損傷及損傷性膽管狹窄的現代外科處理[J].中華消化外科雜志, 2008, 7(1):6-8.
24. 姜洪池, 高越.醫源性膽道損傷的不可忽視性及其防治策略[J].中華肝膽外科雜志, 2005, 11(3):152-154.
25. 楊堅, 苗雄鷹, 陳湘平, 等. 49例腹腔鏡膽囊切除術所致醫源性膽管損傷的處理[J].中國現代手術學雜志, 2013, 17(3):181-183.
26. 張永杰.如何掌握膽管損傷后再手術時間[J].肝膽外科雜志, 2004, 12(3):166-168.
27. 黃強, 劉臣海, 王成, 等.梗阻性膽道損傷修復時機的實驗研究[J].實用醫學雜志, 2011, 27(3):389-391.
28. Slater K, Strong RW, Wall DR, et al. Iatrogenic bile duct injury:the sourage of laparoscopic cholecystectomy[J]. ANZ J Surg, 2002, 72(2):83-88.
29. 李徽, 李全輝, 陳雨信.膽道空腸Roux-en-Y吻合術[J].中華現代外科學雜志, 2008, 5(8):591-592.
30. 范愛國, 張富, 楊國興.空腸人工瓣膜成形在膽道Roux-en-Y吻合術中的應用[J].中國現代普通外科進展, 2011, 14(7):566-567.
31. 郭永生, 張衛東.特殊術后病人的介入輔助治療3例[J].現代保健:醫學創新研究, 2007, 4(36):45-46.
32. 谷化劍, 馮賢松, 辛小燕.醫源性膽道損傷的原因分析與防治策略[J].中國普通外科雜志, 2013, 22(2):192-196.
33. Ardiles V, MeCormack L, Qui?onez E, et al. Experience using liver transplantation for the treatment of severe bile duct injuries over 20 years in Argentina:results from a National Survey[J]. HPB(Oxford), 2011, 13(8):544-550.
34. Vitale GC, Tran TC, Davis BR, et al. Endoscopic management of postcholecystectomy bile duct strictures[J]. J Am Coll Surg, 2008, 206(5):918-923.

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Advances in Clinical Diagnosis and Treatment of Iatrogenic Bile Duct Injury

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