Tiwari Charu, Makhija Om Prakash, Makhija Deepa, Jayaswal Shalika, Shah Hemanshi
Department of Paediatric Surgery, TNMC and BYL Nair Hospital, Mumbai Central, Mumbai, India.
Pediatr Gastroenterol Hepatol Nutr. 2016 Dec;19(4):281-285. doi: 10.5223/pghn.2016.19.4.281. Epub 2016 Dec 28.
Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP). However, surgical exploration is required in cases not responding to non-operative management. If not managed on time, such injuries can lead to severe hepatic damage. We describe a case of an eight-year-old girl who presented with biloma formation after laparoscopic cholecystectomy who was managed by ERCP.
腹腔镜胆囊切除术在儿科年龄组中虽属罕见的外科手术,但与开放手术相比,术后胆管损伤风险仍较高。肝外胆道系统的小渗漏通常会导致局限性肝下胆汁积聚形成,也称为胆汁瘤。这种渗漏是腹腔镜胆囊切除术后罕见的并发症,尤其是在儿科年龄组。轻微胆汁渗漏通常可通过经皮引流联合内镜逆行胰胆管造影术(ERCP)进行非手术处理。然而,对非手术治疗无反应的病例则需要进行手术探查。如果不及时处理,此类损伤可能导致严重肝损伤。我们描述了一例8岁女孩,她在腹腔镜胆囊切除术后出现胆汁瘤形成,通过ERCP进行了治疗。