Kannan Umashankkar, Parshad Rajinder, Regmi Subodh Kumar
Department of Surgical Disciplines, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
Cases J. 2009 Sep 10;2:8048. doi: 10.1186/1757-1626-0002-0000008048.
A 34-year-old female presented with right hypochondrial pain of 6 months following an uneventful open cholecystectomy about 5 years ago. A firm intra abdominal lump was felt in the right hypochondrium. Ultrasonography and computed tomography of the abdomen showed a large cystic lesion in relation to the porta hepatis. On exploration, a large cystic mass was found in relation to the undersurface of liver, adherent to the colon and duodenum. The cyst was excised leaving a cuff of cyst wall, densely adherent to the duodenum. A small opening with bile trickling through it was noted in the region of the confluence of hepatic ducts. Choledochotomy was done and T-tube placed. The bilious output from the sub-hepatic drain gradually decreased and the repeat T-tube cholangiogram on 14th day following surgery was normal. The patient, at one year of follow-up is asymptomatic with normal liver function tests.
一名34岁女性,约5年前接受了顺利的开腹胆囊切除术后6个月出现右季肋部疼痛。在右季肋部可触及一个质地坚硬的腹腔内肿块。腹部超声和计算机断层扫描显示肝门处有一个大的囊性病变。手术探查时,发现肝脏下表面有一个大的囊性肿块,与结肠和十二指肠粘连。切除囊肿时保留了一层紧密粘连于十二指肠的囊肿壁。在肝管汇合处可见一个有胆汁渗出的小开口。进行了胆总管切开术并放置了T形管。肝下引流管的胆汁引流量逐渐减少,术后第14天复查T形管胆管造影正常。随访一年,患者无症状,肝功能检查正常。