Carrel T, Lerut J, Baer H, Blumgart L H
Clinic for Visceral and Transplantation Surgery, University Hospital, Bern, Switzerland.
Eur J Surg. 1991 Mar;157(3):209-13.
Experience of seven consecutive cases of liver abscess following biliary tract surgery is presented. The age range was 41-83 years, and six of the patients were women. The interval from operation to appearance of abscess was 10 days to 14 months. Primary surgical drainage was used in two patients, who remained clinically well 6 months and 2 years later. Four of five patients with initially percutaneous drainage subsequently underwent operative drainage, but one refused further surgery and died 8 days later of sepsis. Multiple factors may predispose to both cholangitis and hepatic abscess following biliary tract surgery. Radiologic investigation of abscess must also focus on identifying underlying biliary pathology. Bactericholia and obstructed bile flow are two of the most important etiologic factors in hepatic abscess after biliary surgery. Experience with these cases suggests that a surgical approach may be preferable to percutaneous techniques in management also of the associated biliary pathology.
本文介绍了7例连续发生的胆道手术后肝脓肿病例的经验。患者年龄在41至83岁之间，其中6例为女性。从手术到脓肿出现的间隔时间为10天至14个月。2例患者采用了一期手术引流，术后6个月和2年临床情况良好。5例最初采用经皮引流的患者中有4例随后接受了手术引流，但1例拒绝进一步手术，8天后死于败血症。多种因素可能导致胆道手术后胆管炎和肝脓肿的发生。对脓肿的影像学检查还必须着重于识别潜在的胆道病变。胆源性菌血症和胆汁流动受阻是胆道手术后肝脓肿最重要的两个病因。这些病例的经验表明，在处理相关胆道病变时，手术方法可能比经皮技术更可取。
