Department of Radiology, Mita Hospital, International University of Health and Welfare, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan.
NTT Medical Center, Tokyo, Japan.
Abdom Radiol (NY). 2019 Apr;44(4):1217-1222. doi: 10.1007/s00261-018-1875-7.
We reviewed six cases suspected of having fish bones in the bile ducts on follow-up CT following pancreaticoduodenectomy. The period from surgery to CT examination in which fishbone migration was first suspected ranged from 282 to 1157 days with a median of 517 days. The fish bone in the bile duct disappeared in five out of six cases on subsequent CT. One case was complicated by hepatolithiasis, and the other five cases showed no biliary complications. In two cases, wandering of fish bones in the jejunal limb was observed on CT images before their migration into the bile ducts. Asymptomatic migration of fish bones to the bile ducts following pancreaticoduodenectomy is not rare, but serious complications can occasionally occur. Indications of intervention may be controversial in asymptomatic cases, but once fish bones are observed in the biliary tree or the jejunal limb, dietary instructions advising not to swallow fish bones may be a good option to prevent complications.
我们复习了 6 例在胰十二指肠切除术后随访 CT 中怀疑有胆管鱼骨的病例。从手术到首次怀疑鱼骨迁移的 CT 检查的时间间隔为 282 至 1157 天，中位数为 517 天。在随后的 CT 中，6 例中的 5 例胆管中的鱼骨消失。1 例合并肝胆管结石，5 例无胆管并发症。在 2 例病例中，在鱼骨迁移至胆管之前，在 CT 图像上观察到鱼骨在空肠支中游荡。胰十二指肠切除术后无症状的鱼骨迁移至胆管并不罕见，但偶尔也会发生严重并发症。无症状病例的介入指征可能存在争议，但一旦在胆道或空肠支中观察到鱼骨，建议不要吞食鱼骨的饮食指导可能是预防并发症的一个好选择。
