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腹腔镜胆囊切除术后继发于卢氏副胆管的胆漏

Post-laparoscopic cholecystectomy bile leak secondary to an accessory duct of Luschka.

作者信息

Jamshidi M, Obermeyer R J, Garcia G, Hashmi M

机构信息

Department of Surgery, Western Reserve Care System, A Division of Forum Health, Youngstown, Ohio 44501, USA.

出版信息

Int Surg. 1999 Jan-Mar;84(1):86-8.

Abstract

Intraperitoneal bile collection following laparoscopic cholecystectomy has been reported to occur in 0.2-2% of cases and appears to be slightly higher than when the open technique is used. When the injuries of the common bile duct, technical problems with the cystic duct, diathermic injuries to the biliary tree, and iatrogenic interruption of congenital anomalous of the biliary tree are excluded, the iatrogenic transaction of the cholecystohepatic ducts commonly known as the 'Ducts of Luschka' should be considered as the cause of the biliary leak. This article reports a case of bile leakage due to an unrecognized division of a large duct of Luschka within the gall bladder fossa during laparoscopic cholecystectomy and reviews clinical diagnosis, radiological confirmation, and the appropriate treatment for this uncommon complication of laparoscopic cholecystectomy.

摘要

据报道,腹腔镜胆囊切除术后腹腔内胆汁积聚的发生率为0.2%-2%,似乎略高于采用开放手术时的发生率。排除胆总管损伤、胆囊管技术问题、胆道树的电灼损伤以及医源性中断胆道树先天性异常等情况后,医源性切断通常称为“卢氏管”的胆囊肝管应被视为胆汁漏的原因。本文报告了1例在腹腔镜胆囊切除术中胆囊窝内一条大的卢氏管未被识别而切断导致胆汁漏的病例,并对这种腹腔镜胆囊切除术罕见并发症的临床诊断、影像学确认及适当治疗进行了综述。

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