【摘要】 目的 探讨医源性胆总管远段损伤的术中诊治及预防。方法 回顾性分析1990年2月～2005年2月我科收治的26例医源性胆总管远段损伤患者的临床资料。结果 胆扩裸露征(96.2%)，注水试验阳性(100%)。外科治疗遵循浅、通、撑、抑4字原则，长臂T管支撑胆总管是有效的手段。全组21例获得随访，平均20.8个月，效果满意。结论 术中胆扩裸露征、注水试验是胆总管远段损伤的有效诊断手段。遵循浅、通、撑、抑4字外科原则，可获满意效果。满意的术野显露是有效的预防措施。

    【关键词】 医源性胆总管远段损伤；诊断；治疗；预防

    Intraoperative diagnosis and prevention of iatrogenic choledochus injury

    WU Jin-shu,LIANG Gang,CHEN Mei-fu,et al.

    Hunan Provincial Hospital,Changsha 410002,China

    【Abstract】 Objective To discuss the diagnosis and prevention of iatrogenic choledochus injury during operation.Methods Reviewed the case history of above-mentioned reason that treated in department from 1990,2～2005,2.Results Biliary tract sound nudity sign(96.2) water affusion-

    test (+)100%:the surgical treatment follow four words principle:superficial,communicate,hold,restrain.Using the long arm T tube to support the common bile duct is effect method.Visiting 21 cases,average times are 20.8 months,the effect is satisfying.Conclusion The affusion-test is utility method to diagnose the distal common bile duct injury in operation.Flowing the above mentioned four words principle make the result satisfying.satisfied operation visual field is an effective prevention method. ......