胆道(Luschka管)异常:1例报告及文献复习

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引用次数: 0

摘要

它们是副胆管,直径小于2mm,与胆囊床接触,最常依赖于右肝叶。临床病例:41岁男性,无合并症,行腹腔镜胆囊切除术,术中发现副胆管胆漏。进行双结扎。术后患者临床进展良好。没有积液,瘘管或任何并发症的迹象。讨论:不同的病例系列表明,腹腔镜胆囊切除术中的损伤通常在手术过程中或更常见的是在术后立即发现。术后立即出现胆汁通过引流管或腹膜排出的迹象应提示胆道损伤。胆汁的局部积聚可产生无菌胆囊瘤、肝下或肝间脓肿。结论:胆漏的存在、临床表现、诊断、分类、复杂性和适当的治疗可以降低患者的发病率和死亡率,因此在任何胆囊切除术(无论是开放式还是腹腔镜)之前都必须进行监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abnormality of the Bile Tract (Luschka Duct): Case Report and Literature Review
Introduction: They are accessory bile ducts, less than 2 mm in diameter, they are in contact with the gallbladder bed, they depend on the right hepatic lobe most frequently. Clinical case: A 41-year-old male patient without comorbidities underwent laparoscopic cholecystectomy, during which bile leak from the accessory duct was detected. Double ligation was performed. During the postsurgical period, the patient presented a good clinical evolution. No evidence of collections, fistulas or any complications. Discussion: Different case series demonstrate that injuries during laparoscopic cholecystectomy are usually recognized during the procedure or more commonly in the immediate postoperative period. In the immediate postoperative period, the presence of bile output through a drain or peritoneal signs should imply a biliary injury. Localized accumulation of bile can produce a sterile bilioma , subhepatic or interhepatophrenic abscess . Conclusions: Surveillance must be exercised before any cholecystectomy, whether open or laparoscopic, since the presence of bile leak, its clinical presentation, diagnosis, classification, complexity and adequate treatment can reduce morbidity and mortality in the patient.
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