Erdogan Deha, Busch Olivier R C, Gouma Dirk J, van Gulik Thomas M
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Dig Surg. 2007;24(4):294-9. doi: 10.1159/000103661. Epub 2007 Jul 27.
Liver resection is widely accepted as the only potentially curative treatment in malignant or benign hepatobiliary lesions. Although not frequent, biliary leakage is a postoperative complication which may have considerable consequences. The field of topical hemostatic agents is rapidly developing, with various products currently available. This article reviews the risk factors associated with biliary leakage and the methods used for testing or prevention of biliary leakage. A literature search was performed using key words related to experimental and clinical studies dealing with biliary leakage. Experimental studies assessed the potential bilio-static effect of different topical hemostatic agents after bile duct reconstruction. Clinical series show biliary leakage rates up to 12%. There is no evidence that flushing of the bile duct system after resection reduces the incidence of biliary leakage. Further controlled studies are needed to clarify the preventive effect of topical hemostatic agents on biliary leakage after liver resection.
肝切除术被广泛认为是治疗恶性或良性肝胆病变唯一具有潜在治愈可能的治疗方法。尽管并不常见，但胆漏是一种术后并发症，可能会产生相当严重的后果。局部止血剂领域正在迅速发展，目前有各种产品可供使用。本文综述了与胆漏相关的危险因素以及用于检测或预防胆漏的方法。使用与胆漏相关的实验和临床研究的关键词进行了文献检索。实验研究评估了胆管重建后不同局部止血剂的潜在胆静息作用。临床系列研究显示胆漏发生率高达12%。没有证据表明切除术后冲洗胆管系统可降低胆漏发生率。需要进一步的对照研究来阐明局部止血剂对肝切除术后胆漏的预防作用。
