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小儿腹腔镜胆囊切除术后胆漏经内镜逆行胰胆管造影及支架置入治疗:一例报告

Post Laparoscopic Cholecystectomy Biloma in a Child Managed by Endoscopic Retrograde Cholangio-Pancreatography and Stenting: A Case Report.

作者信息

Tiwari Charu, Makhija Om Prakash, Makhija Deepa, Jayaswal Shalika, Shah Hemanshi

机构信息

Department of Paediatric Surgery, TNMC and BYL Nair Hospital, Mumbai Central, Mumbai, India.

出版信息

Pediatr Gastroenterol Hepatol Nutr. 2016 Dec;19(4):281-285. doi: 10.5223/pghn.2016.19.4.281. Epub 2016 Dec 28.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4bdc/5234419/ad7d96135609/pghn-19-281-g001.jpg

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