Carrafiello Gianpaolo, Laganà Domenico, Dizonno Massimiliano, Ianniello Andrea, Cotta Elisa, Dionigi Gianlorenzo, Dionigi Renzo, Fugazzola Carlo
Department of Radiology, University of Insubria, Varese, Italy.
Emerg Radiol. 2008 Sep;15(5):335-41. doi: 10.1007/s10140-008-0719-0. Epub 2008 May 8.
The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.
本研究的目的是评估急诊经皮治疗手术性胆管损伤(SBDI)患者的疗效。2004年5月至2007年5月,对11例因手术或腹腔镜手术继发SBDI而出现危急临床表现(严重黄疸、胆汁性腹膜炎、脓毒症)的患者进行了经皮治疗。我们进行了4次超声引导下经皮引流、4次内外胆管引流、1次胆管成形术以及在放置内外胆管引流2周后进行了2次塑料胆管支架置入术。所有手术技术成功率均为100%,无并发症发生。100%的病例临床急症在3至4天内得到缓解。所有患者临床病程均呈良性,100%的病例避免了再次手术。介入放射学方法在SBDI的急诊处理中有效,因为与更复杂、危险的手术或腹腔镜选择相比,它们微创、成功率高且并发症发生率低。