[胆囊切除术后胆管损伤:俄罗斯联邦的现状]
A Sh Revishvili1, V E Olovyanny1, P V Markov1
1Vishnevsky National Medical Research Center of Surgery, Moscow, Russia.
Khirurgiia
|January 27, 2026
概括
胆囊切除术期间的阳性胆道损伤 (BDI) 通常是由由于炎症而难以识别胆道引起的. 坚持安全胆囊切除术原则和及时诊断对于改善患者的治疗结果至关重要.
科学领域:
- 胃肠道学和肝胆道外科
- 手术安全与并发症
- 医疗设备和技术评估 医疗设备和技术评估
背景情况:
- 阳性胆道损伤 (BDI) 是胆囊切除术期间的一个重大并发症.
- 了解俄罗斯联邦BDI的现状对于改善患者护理和外科培训至关重要.
研究的目的:
- 评估俄罗斯联邦阳性胆道损伤 (BDI) 的发生率,原因和管理.
- 分析在BDI病例中影响手术结果的因素.
主要方法:
- 对2023年需要重建性手术的BDI病例进行回顾性分析.
- 通过在线调查向俄罗斯卫生部首席外科医生报告BDI的医疗机构收集数据.
主要成果:
- 确定了227个BDI,分析了126名患者的数据. 腹腔镜胆囊切除术是最常见的手术 (84.9%).
- 导致BDI的主要原因是由于纤维性炎症变化导致难以识别胆道 (83.3%). 最常见的是E型 (94例) 和D型 (32例) 的伤害.
- 在15.9%的病例中出现并发症,而13%的病例是肝结合性静脉功能衰竭. 总体死亡率为4.8%.
结论:
- 肝下空间的纤维性炎症变化是胆囊切除术期间BDI的主要原因.
- 坚持安全胆囊切除术的原则和迅速转诊专业中心对于最佳管理至关重要.
- 及时诊断和适当的外科干预显著改善了BDI患者的结果.
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