Choi Kun Moo, Jang Hyuk Jai, Kwak Jin Ho, Kim Ji Hoon, Ahn Jae Hong
Hepatogastroenterology. 2014 Jan-Feb;61(129):27-30.
Laparoscopic cholecystectomy (LC) is the treatment of choice for gallbladder stones. One of the major complications associated with LC is bile duct injury; ligation or cutting of a bile duct can result in significant segmental biliary obstruction with cholangitis or bile leak, which can progress to bile peritonitis or biliary fistula. Most postoperative bilomas and bile leaks can be treated by percutaneous drainage and decompression of the biliary system by endoscopic stent placement or nasobiliary drainage. When conservative methods fail despite prolonged drainage, selective intrahepatic biliary ethanol and micro-coil embolization may be an alternative treatment. We report three successful cases where postoperative bilomas associated with laparoscopic cholecystectomy have been managed with intrabiliary ethanol ablation and micro-coil embolization.
腹腔镜胆囊切除术(LC)是胆囊结石的首选治疗方法。与LC相关的主要并发症之一是胆管损伤;胆管结扎或切断可导致严重的节段性胆管梗阻,并伴有胆管炎或胆漏,进而可发展为胆汁性腹膜炎或胆瘘。大多数术后胆汁瘤和胆漏可通过经皮引流以及通过内镜支架置入或鼻胆管引流对胆道系统进行减压来治疗。当尽管长时间引流但保守方法仍失败时,选择性肝内胆管乙醇和微线圈栓塞术可能是一种替代治疗方法。我们报告了三例成功的病例,其中与腹腔镜胆囊切除术相关的术后胆汁瘤通过胆管内乙醇消融和微线圈栓塞术得到了治疗。