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腹腔镜胆囊切除术后十二指肠损伤的保守治疗方案。

An option of conservative management of a duodenal injury following laparoscopic cholecystectomy.

作者信息

Modi Ma, Deolekar Ss, Gvalani Ak

机构信息

Department of General Surgery, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Parel, Mumbai 400012, India.

出版信息

Case Rep Surg. 2014;2014:398545. doi: 10.1155/2014/398545. Epub 2014 Oct 21.

Abstract

Duodenal injury following laparoscopic cholecystectomy is rare complications with catastrophic sequelae. Most injuries are attributed to thermal burns with electrocautery following adhesiolysis and have a delayed presentation requiring surgical intervention. We present a case of a 47-year-old gentleman operated on for laparoscopic cholecystectomy with a bilious drain postoperatively; for which an ERC was done showing choledocholithiasis with cystic duct stump blow-out and a drain in the duodenum suggestive of an iatrogenic duodenal injury. He was managed conservatively like a duodenal fistula and recovered without undergoing any intervention.

摘要

腹腔镜胆囊切除术后十二指肠损伤是一种罕见的并发症,会导致灾难性后果。大多数损伤是由于粘连松解后电灼造成的热灼伤,且表现延迟,需要手术干预。我们报告一例47岁男性患者,接受了腹腔镜胆囊切除术,术后留置胆汁引流管;为此进行了内镜逆行胰胆管造影(ERC),显示胆总管结石伴胆囊管残端破裂,十二指肠内有引流管,提示医源性十二指肠损伤。他接受了类似十二指肠瘘的保守治疗,未进行任何干预即康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cee/4221966/88036d8ad0bf/CRIS2014-398545.001.jpg

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