医源性胆管损伤后复杂胆管狭窄的处理
Management for a complicated biliary stricture after iatrogenic bile duct injury.
作者信息
Suo Tao, Chen Ling, Liu Han, Ni Xiaoling, Shen Sheng, Wang Yueqi, Liu Houbao
机构信息
Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200030, China.
出版信息
J Vis Surg. 2017 Mar 17;3:33. doi: 10.21037/jovs.2017.03.06. eCollection 2017.
Abstract
Bile duct injury (BDI) remains to be a serious complication of biliary surgery. Biliary stricture is likely to occur in cases without proper management of BDI, may be causing such severe complications as repeated strictures, cholangitis or impairment to liver function. Here, we reported a 69-year-old man with a one-more-year history of recurrent cholangitis caused by iatrogenic BDI. The patient underwent a reconstruction of choledochojejunostomy, with liver quadrate lobectomy, and hilar cholangioplasty. The procedure was difficult, but the recovery was smooth. Only through comprehensive pre-operative evaluation and meticulous intraoperative manipulate, the technical challenge of re-operation for complicated biliary stricture after BDI should be easily addressed.
摘要
胆管损伤（BDI）仍然是胆道手术的一种严重并发症。在未对BDI进行妥善处理的情况下，胆管狭窄很可能发生，可能会引发反复狭窄、胆管炎或肝功能损害等严重并发症。在此，我们报告了一名69岁男性，因医源性BDI导致复发性胆管炎长达一年多。该患者接受了胆总管空肠吻合术重建、肝方叶切除术和肝门胆管成形术。手术过程困难，但恢复顺利。只有通过全面的术前评估和细致的术中操作，才能轻松应对BDI后复杂胆管狭窄再次手术的技术挑战。
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