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经皮胆囊结石取出术。

Percutaneous Retrieval of Retained Gallstones.

机构信息

Department of Surgery, Reading Hospital-Tower Health, West Reading, PA, USA.

Department of Interventional Radiology, Reading Hospital-Tower Health, West Reading, PA, USA.

出版信息

Am Surg. 2023 Jun;89(6):2918-2919. doi: 10.1177/00031348221084944. Epub 2022 Mar 25.

Abstract

Laparoscopic cholecystectomy has become the gold standard for patients with gallbladder disease. However, spilled gallstones occur in up to 18% of laparoscopic cholecystectomies, which may result in retained gallstones. Though most do not cause issues, there may be abscess formation from 4 months to 10 years postoperatively. We present a 78-year-old patient who formed a subhepatic abscess 3 months postoperatively from his laparoscopic cholecystectomy secondary to a 1 cm retained gallstone. The abscess was percutaneously drained by interventional radiology (IR), and the stone was subsequently removed by IR using a percutaneous approach. Open and laparoscopic approaches have been previously described for abscess drainage and removal of gallstones. In this case, both the abscess and stone were drained and removed percutaneously by IR. Though this is an uncommon entity, percutaneous decompression can aid in preventing such patients from undergoing additional surgery.

摘要

腹腔镜胆囊切除术已成为胆囊疾病患者的金标准。然而,多达 18%的腹腔镜胆囊切除术中会发生胆囊结石脱落,这可能导致残余结石。尽管大多数情况下不会引起问题,但术后 4 个月至 10 年内可能会形成脓肿。我们现介绍一位 78 岁的患者,他在腹腔镜胆囊切除术后 3 个月因 1 厘米的残余结石形成肝下脓肿。脓肿通过介入放射学(IR)经皮引流,随后通过 IR 经皮途径取出结石。开放和腹腔镜方法以前曾用于脓肿引流和胆囊结石的取出。在这种情况下,IR 同时对脓肿和结石进行了经皮引流和清除。尽管这是一种罕见的情况,但经皮减压可以帮助防止此类患者接受额外的手术。

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