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腹腔镜胆囊切除术期间的医源性胆管损伤

Iatrogenic bile duct injury during laparoscopic cholecystectomy.

作者信息

Saad Nael, Darcy Michael

机构信息

Mallinckrodt Institute of Radiology, Washington University, St. Louis, MO 63110, USA.

出版信息

Tech Vasc Interv Radiol. 2008 Jun;11(2):102-10. doi: 10.1053/j.tvir.2008.07.004.

Abstract

Laparoscopic cholecystectomy has largely replaced open cholecystectomy as the standard of care for gallbladder excision. A major disadvantage of this trend has been the increased incidence of bile duct injuries, which, while uncommon, are significantly higher with laparoscopic cholecystectomy. Most injuries are not recognized at the time of surgery and present in a delayed fashion, leading to significant patient morbidity and a negative impact on the quality of life of patients. Treatment is governed by the time of presentation and the nature of the bile duct injury incurred and requires a multidisciplinary approach. Radiologists play a key role in management, with diagnosis of complications, accurate depiction of the biliary injury, and facilitating or providing definitive therapy depending on the type of injury.

摘要

腹腔镜胆囊切除术已在很大程度上取代了开腹胆囊切除术,成为胆囊切除的标准治疗方法。这种趋势的一个主要缺点是胆管损伤的发生率增加,虽然这种情况并不常见,但在腹腔镜胆囊切除术中显著更高。大多数损伤在手术时未被识别,而是以延迟的方式出现,导致患者出现严重的发病情况,并对患者的生活质量产生负面影响。治疗取决于就诊时间和所发生的胆管损伤的性质,需要多学科方法。放射科医生在管理中发挥关键作用,包括并发症的诊断、胆管损伤的准确描述,以及根据损伤类型促进或提供确定性治疗。

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