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腹腔镜胆囊切除术后并发肝内包膜下血肿

Intrahepatic subcapsular hematoma complicating laparoscopic cholecystectomy.

作者信息

Bhandarkar D S, Katara A N, Shah R S

机构信息

Department of Minimal Access Surgery, P. D. Hinduja National Hospital & Medical Research Centre, Veer Savrakar Marg, Mahim, 400 016 Mumbai, India.

出版信息

Surg Endosc. 2004 May;18(5):868-70. doi: 10.1007/s00464-003-4540-2. Epub 2004 Feb 2.

Abstract

A 64-year-old woman underwent endoscopic retrograde cholangiopancreatography for bile duct stones, followed 2 days later by an uneventful laparoscopic cholecystectomy. She presented after 10 days with upper abdominal discomfort, nausea, and pyrexia. Investigations revealed a decrease in hemoglobin, and computed tomography identified a large intrahepatic subcapsular hematoma in segments V and VI. There was no intraabdominal collection and the rest of the viscera were normal. The collection was drained percutaneously under ultrasound guidance and a wide-bore catheter placed. She was treated with intravenous antibiotics and the catheter was removed 14 days later upon cessation of drainage. Serial ultrasonographic examinations showed a reduction in the size of the hematoma and complete resolution at 4 months. She remained well and asymptomatic at follow-up 16 months later. We report this case due to its rarity and review the previously documented cases of this complication.

摘要

一名64岁女性因胆管结石接受了内镜逆行胰胆管造影术,两天后顺利进行了腹腔镜胆囊切除术。10天后,她出现上腹部不适、恶心和发热。检查发现血红蛋白降低,计算机断层扫描显示肝V段和VI段有一个巨大的肝内包膜下血肿。腹腔内没有积液,其他内脏正常。在超声引导下经皮引流血肿,并置入一根粗导管。她接受了静脉抗生素治疗,14天后引流停止时拔除导管。系列超声检查显示血肿大小缩小,4个月时完全消退。16个月后的随访中,她情况良好且无症状。我们报告此病例是因其罕见性,并回顾了此前记录的该并发症病例。

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