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腹腔镜胆囊切除术后10年因胆石溢出导致的急腹症:诊断难题

Acute abdomen due to spilled gallstones: a diagnostic dilemma 10 years after laparoscopic cholecystectomy.

作者信息

Kafadar Mehmet Tolga, Çetinkaya İsmail, Aday Ulaş, Başol Ömer, Bilge Hüseyin

机构信息

Dicle University School of Medicine, Department of General Surgery, Diyarbakır, Turkey.

Health Sciences University, Mehmet Akif İnan Training and Research Hospital Clinic of General Surgery, Şanlıurfa, Turkey.

出版信息

J Surg Case Rep. 2020 Aug 24;2020(8):rjaa275. doi: 10.1093/jscr/rjaa275. eCollection 2020 Aug.

Abstract

Laparoscopic cholecystectomy (LC) carries a significant risk of gallbladder perforation and resulting scattering of bile stones into the abdominal cavity. The retrieval of the spilled stones is not always possible by laparoscopic technique. Most cases do not create long-term problems, although some cases may be complicated in future and create uncertainties regarding the correct diagnosis. Diagnosis can be difficult, and in most cases the patient may require open surgery for management of these complications. Herein, we report a case of acute abdomen due to spilled stones occurring 10 years after LC. In the first stage, definitive diagnosis could not be made with computed tomography examination. Finally, the patient was diagnosed with explorative laparotomy.

摘要

腹腔镜胆囊切除术(LC)存在胆囊穿孔以及胆结石散落至腹腔的重大风险。通过腹腔镜技术并不总能取出溢出的结石。大多数情况下不会产生长期问题,尽管有些病例未来可能会出现并发症,并在正确诊断方面带来不确定性。诊断可能会很困难,在大多数情况下,患者可能需要接受开放手术来处理这些并发症。在此,我们报告一例在腹腔镜胆囊切除术后10年因结石散落导致急腹症的病例。在第一阶段,计算机断层扫描检查未能做出明确诊断。最终,患者通过剖腹探查术得以确诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbf4/7444308/5eb24c22e35c/rjaa275f1.jpg

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