Objective To investigate the cause, diagnosis and treatment of iatrogenic bile duct injury, thus to reduce the incidence of iatrogenic bile duct injury and improve clinical treatment efficiency. Methods The clinical data of 24 patients with iatrogenic bile duct injury in June 2006 to December 2011 were retrospectively analyzed. 12 cases that completed surgery within 12 hours after the onset of the disease were chosen as group A and 12 cases that completed surgery within 24 hours after the onset of the disease were chosen as group B, and combined with literature analysis, the common cause, diagnosis and treatment methods of the disease were analyzed and the effect of different periods of treatment on the prognosis of patients were also analyzed. Results In group A, patients' postoperative hospital stay were (16.5±2.7) days and the cost of treatment were (21 590.5±859.6) yuan, which were significantly different than that of group B [(24.2±4.1) days and (35 421.2±1 462.2) yuan] (t = 8.857, 157.629, P < 0.05). SAS scores after surgery one day and upon discharge were (49.20± 12.04) scores and (34.15±4.82) scores in group A, which were significantly different than that of group B [(58.20±19.37) scores and (42.50±17.24) scores] (t = 16.420, 13.424, P < 0.05). SDS scores after surgery one day and upon discharge were (46.42± 11.66) scores and (30.42±8.99) scores in group A, which were significantly different than that of group B [(55.48± 11.67) scores and (40.17±10.63) scores] (t = 15.897, 17.690, P <0.05). Conclusion Early diagnosis and treatment of bile duct injury can effectively avoid the injury of secondary surgery and thus improve outcomes of the disease.%目的 探讨发生医源性胆道损伤的原因、诊治方法,降低医源性胆道损伤的发生率,提高临床治疗效率.方法 回顾性分析2006年6月~2011年12月发生医源性胆道损伤24例患者的临床资料,选取其中12例发病后12 h内完成手术的患者为A组,以发病24 h后完成治疗的12例患者为B组,并结合相关文献分析发生医源性胆道损伤的常见原因和诊治方法,比较不同时期治疗对患者预后的影响.结果 A组患者术后住院时间为(16.5±2.7)d,治疗费用为(21 590.5±859.6)元,B组分别为(24.2±4.1)d和(35 421.2±1 462.2)元,组间比较差异有统计学意义(t = 8.857、157.629,P < 0.05).A组患者术后1 d和出院时SAS评分分别为(49.20±12.04)分和(34.15±4.82)分;B组分别为(58.20±19.37)分和(42.50±17.24)分,组间比较差异有统计学学意义(t = 16.420、13.424,P < 0.05).A组患者术后1 d和出院时SDS评分分别为(46.42±11.66)分和(30.42±8.99)分,B组分别为(55.48±11.67)分和(40.17±10.63)分,组间比较差异具有统计学学意义(t = 15.897、17.690,P < 0.05).结论 早期诊断和治疗胆道损伤,可有效避免二次手术对患者的伤害,改善患者预后.
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