Donatelli Gianfranco, Mutter Didier, Dhumane Parag, Callari Cosimo, Marescaux Jacques
Department of Gastrointestinal and Endocrinal Surgery, IRCAD/EITS, University of Strasbourg, Strasbourg, France.
J Minim Access Surg. 2012 Jul;8(3):99-101. doi: 10.4103/0972-9941.97599.
Laparoscopic cholecystectomy is still associated with a considerable rate of biliary injuries and related strictures. Advances in interventional endoscopy and percutaneous techniques have made stenting a preferred treatment modality for the management of these strictures. We report successful 20 years of follow-up of a case of trans-hepatic metallic stenting (2 Gianturco(®) prostheses, 5 cm long, 2 cm in diameter) done for stenosed hepatico-jejunostomy anastomosis after laparoscopic CBD injury. Percutaneous transhepatic stenting and long-term placement of metallic stents need to be re-evaluated as a minimally invasive definitive treatment option for benign biliary strictures in patients with altered anatomy such as hepatico-jejunostomy or in whom re-operation involves high risk.
腹腔镜胆囊切除术仍与相当高的胆管损伤及相关狭窄发生率相关。介入内镜和经皮技术的进展使支架置入成为治疗这些狭窄的首选方式。我们报告了一例因腹腔镜胆总管损伤后肝空肠吻合口狭窄行肝内金属支架置入术（2个直径2cm、长5cm的Gianturco® 支架）患者成功随访20年的情况。对于解剖结构改变（如肝空肠吻合术）或再次手术风险高的患者，经皮肝内支架置入及金属支架长期放置作为良性胆管狭窄的微创确定性治疗选择需要重新评估。
