Dasari Bobby V M, Loan William, Carey Declan P
Belfast City Hospital, Belfast Health and Social Care Trust, Belfast, BT9 7AB, United Kingdom.
JSLS. 2009 Jan-Mar;13(1):73-6.
Spillage of bile and gallstones due to accidental perforation of the gallbladder wall is often encountered during laparoscopic cholecystectomy. Although spilled stones were once considered harmless, there is increasing evidence that they can result in septic or other potential complications.
We report a case of spilled gallstones mimicking peritoneal metastases on radiological investigations; diagnosis was confirmed by diagnostic laparoscopy.
Every effort should be made to retrieve spilled gallstones during laparoscopic cholecystectomy. When all the stones cannot be retrieved, it should be documented in the patient's medical records to avoid delay in the diagnosis of late complications. Diagnostic laparoscopy is useful when the radiological investigations are inconclusive.
在腹腔镜胆囊切除术中,胆囊壁意外穿孔导致胆汁和胆结石溢出的情况经常出现。尽管曾经认为溢出的结石无害,但越来越多的证据表明它们可导致感染或其他潜在并发症。
我们报告一例在影像学检查中被误诊为腹膜转移的溢出胆结石病例;通过诊断性腹腔镜检查确诊。
在腹腔镜胆囊切除术中应尽一切努力取出溢出的胆结石。当无法取出所有结石时,应记录在患者病历中,以避免延迟诊断晚期并发症。当影像学检查结果不明确时,诊断性腹腔镜检查很有用。