Andersson R, Tranberg K G, Bengmark S
Department of Surgery, University Hospital, Lund, Sweden.
Acta Chir Scand. 1988 May-Jun;154(5-6):375-7.
In 1969-1986 intraperitoneal accumulation of bile occurred in 21 patients after elective cholecystectomy or choledochotomy (n = 16) or percutaneous fine-needle cholangiography or biopsy (n = 5). The cause was established in all but one of the surgical cases, viz. T-tube removal (8), injury to the common bile duct (3), unrecognized aberrant bile duct (3) and leakage from liver biopsy (1). The intraperitoneal accumulation of bile led to laparotomy in 19 cases, when the median amount of bile found was 500 ml (range 100-3,500 ml). Mortality was nil, and only few and relatively minor complications could be attributed to the accumulation of bile--pleural effusion (2 cases), wound rupture (1), lower-limb venous thrombosis (1) and strictured hepatojejunostomy (1). There were no infectious complications. It is concluded that intraperitoneal accumulation of bile alone after elective surgical or invasive diagnostic procedures does not usually lead to severe complications, and that it seems distinctly less noxious than the bile peritonitis associated with acute cholecystitis.
1969年至1986年间，21例患者在择期胆囊切除术、胆总管切开术（16例）或经皮细针胆管造影术或活检（5例）后出现胆汁腹腔内积聚。除1例手术病例外，其余病例的病因均已明确，即T管拔除（8例）、胆总管损伤（3例）、未识别的异常胆管（3例）和肝活检渗漏（1例）。19例患者因胆汁腹腔内积聚而行剖腹手术，术中发现胆汁中位数为500毫升（范围100 - 3500毫升）。无死亡病例，仅有少数且相对轻微的并发症可归因于胆汁积聚——胸腔积液（2例）、伤口破裂（1例）、下肢静脉血栓形成（1例）和肝空肠吻合口狭窄（1例）。无感染性并发症。结论是，择期手术或侵入性诊断程序后单纯的胆汁腹腔内积聚通常不会导致严重并发症，而且其毒性似乎明显低于与急性胆囊炎相关的胆汁性腹膜炎。
