Department of Surgery, Rhode Island Hospital, 2 Dudley Street, Suite 370, Providence, RI 02905, USA.
Department of Surgery, Rhode Island Hospital, 2 Dudley Street, Suite 370, Providence, RI 02905, USA.
Surg Clin North Am. 2019 Apr;99(2):283-299. doi: 10.1016/j.suc.2018.11.006. Epub 2019 Feb 10.
Common bile duct injury is a feared complication of cholecystectomy, with an incidence of 0.1% to 0.6%. A majority of injuries go unnoticed at index operation, and postoperative diagnosis can be difficult. Patient presentation can vary from vague abdominal pain to uncontrolled sepsis and peritonitis. Diagnostic evaluation typically begins with ultrasound or CT scan in the acute setting, and source control is paramount at time of presentation. In a stable patient, hepatobiliary iminodiacetic acid scan can be useful in identifying an ongoing bile leak, which requires intervention. A variety of diagnostic techniques define biliary anatomy. Treatment often requires a multidisciplinary approach.
胆总管损伤是胆囊切除术的一种严重并发症，其发生率为 0.1%至 0.6%。大多数损伤在初次手术时未被发现，术后诊断较为困难。患者的表现从模糊的腹痛到无法控制的脓毒症和腹膜炎不等。诊断评估通常在急性情况下从超声或 CT 扫描开始，在出现时最重要的是进行源头控制。对于稳定的患者，肝胆碘代氨基酸扫描可用于识别持续的胆汁漏，这需要进行干预。各种诊断技术可用于确定胆管解剖结构。治疗通常需要多学科方法。
