Furugaki K, Chijiiwa K, Ogawa T, Ogawa Y, Tanaka M
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Int Surg. 2001 Jan-Mar;86(1):67-71.
From 1984 to 1998, a total of 2158 patients underwent hepatobiliary and pancreatic surgery, and 12 patients developed liver abscess after hepatobiliary and pancreatic surgery; thus, the incidence of liver abscess was 0.6%. The main reasons for liver abscess were anastomotic stricture in 5 patients, obstruction of percutaneous transhepatic biliary drainage (PTBD) tube in 3 patients, and portal vein and hepatic artery obstruction due to intraoperative radiation in 1 patient, transportal chemotherapy in 1 patient, chemo-lipiodolization in 1 patient, and unknown in 1 patient. Ten of the 12 patients initially underwent percutaneous transhepatic abscess drainage of whom 2 patients subsequently received surgical drainage. The other 2 patients were treated with antibiotics only. Eight of the 12 patients were cured, but 4 patients died. The reasons for death were sepsis in 3 patients and liver failure due to portal vein and hepatic artery obstruction in 1 patient. Our results indicate that liver abscess should be taken into consideration for patients with risk factors.
1984年至1998年，共有2158例患者接受了肝胆胰手术，其中12例患者在肝胆胰手术后发生肝脓肿，因此肝脓肿的发生率为0.6%。肝脓肿的主要原因包括：吻合口狭窄5例，经皮肝穿刺胆道引流（PTBD）管阻塞3例，术中放疗导致门静脉和肝动脉阻塞1例，经门静脉化疗1例，碘油化疗1例，原因不明1例。12例患者中有10例最初接受了经皮肝穿刺脓肿引流，其中2例随后接受了手术引流。另外2例患者仅接受了抗生素治疗。12例患者中有8例治愈，但4例死亡。死亡原因是3例败血症和1例因门静脉和肝动脉阻塞导致的肝衰竭。我们的结果表明，对于有危险因素的患者应考虑到肝脓肿的发生。
