Nikumbh Tejas, Bhandarwar Ajay, Sanap Shubhangi, Wagholikar Gajanan
Department of Surgery, Grant Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India.
Deenanath Mangeshkar Hospital and Research Centre, Pune, Maharashtra, India.
J Minim Access Surg. 2020 Jan-Mar;16(1):77-79. doi: 10.4103/jmas.JMAS_267_18.
Intra-hepatic perforation of the gallbladder (GB) leading to hepatic abscess is a serious and rare complication of cholecystitis, with very few sporadically reported cases in the literature. Hence, there is no standard approach to treat it. A thorough radiological evaluation with computed tomography and endoscopic retrograde cholangiopancreatography is necessary before proceeding with surgery in such cases. An early laparoscopic intervention to perform a sub-total cholecystectomy with drain placement is enough to treat both cholecystitis and liver abscess in a definitive manner. While previous reports have advocated an open surgery, our series demonstrates that early laparoscopic management is a safe and suitable approach in such cases.
胆囊肝内穿孔导致肝脓肿是胆囊炎一种严重且罕见的并发症，文献中仅有零星几例报道。因此，对于其治疗尚无标准方法。在此类病例进行手术前，有必要通过计算机断层扫描和内镜逆行胰胆管造影进行全面的影像学评估。早期进行腹腔镜干预，行次全胆囊切除术并放置引流管，足以确切治疗胆囊炎和肝脓肿。虽然之前的报道主张采用开放手术，但我们的系列研究表明，早期腹腔镜治疗在此类病例中是一种安全且合适的方法。
