胆囊切除术后右侧后段胆管损伤--单个机构的系列研究。

P. J. Halder, Swapnil Sharma
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引用次数: 0

摘要

扇形胆管损伤与大胆管损伤相比并不常见,由于其罕见性,给诊断和治疗带来了挑战。本文分析了 2000 年至 2020 年期间在一家医疗机构接受治疗的 17 例右后方扇形胆管损伤患者(5 男 12 女)的记录。其中 7 名患者接受了非手术治疗,9 名患者接受了扇形胆管鲁氏肝空肠吻合术(denitive surgery with a sectoral bile ductRoux - en - Y hepaticojejunostomy)。随访时间从 1 年到 11 年不等。一名患者术后出现轻微渗漏;两名患者通过经皮球囊扩张术处理了吻合口狭窄。尽管内镜逆行胰胆管造影术和磁共振胆胰造影术显示胆道解剖结构 "正常",但胆漏仍持续存在,这应导致怀疑右段胆管损伤。对病情的认识、磁共振胆胰造影术±经皮经肝胆管造影术以及专家对造影ndings 的解读是诊断右后段胆管损伤的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
POST-CHOLECYSTECTOMY RIGHT POSTERIOR SECTORAL BILE DUCT INJURY--A SINGLE INSTITUTION SERIES.
Injuries to sectoral bile ducts are less common than their major bile duct counterparts and present diagnostic and therapeutic challenges because of their rarity. Records of 17 patients (5 men and 12 women) with right posterior sectoral bile duct injuries managed in a single institution from year 2000 to 2020 were analysed. Seven patients were managed non - operatively, and 9 patients underwent denitive surgery with a sectoral bile duct Roux – en – Y hepaticojejunostomy. Follow up ranged between 1 to 11 years. One patient had minor post-operative leak; 2 patients had anastomotic narrowing managed by percutaneous balloon dilatation. Persistence of bile leak despite a “normal” biliary anatomy on Endoscopic Retrograde Cholangiography ± Magnetic Resonance Cholangio Pancreatography should lead to a suspicion of a right sectoral bile duct injury. Awareness of the condition, Magnetic Resonance Cholangio Pancreatography ± Percutaneous Transhepatic Cholangiography, and expert interpretation of the ndings of imaging, are the keys to diagnosis of a Right Posterior Sectoral Bile Duct Injury.
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