Justaniah Almamoon, Abughararah Mohamed Z, Ahmad Niaz, Ashour Majed, Alqarni Hassan
Department of Radiology, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.
General Surgery, Hepatobiliary Unit, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.
Cureus. 2023 Feb 15;15(2):e35012. doi: 10.7759/cureus.35012. eCollection 2023 Feb.
Iatrogenic bile duct injury during laparoscopic cholecystectomy is a known complication of low incidence. The outcome can be devastating if not recognized and managed timely and properly. In cases of iatrogenic biliary injury due to cholecystectomy, the management depends on the level of injury, the timing of discovery (intraoperative or postoperative), and the patient's condition. If discovered intraoperatively, the injury should be managed immediately. In case expertise is lacking, a surgical drain with external biliary drainage can provide a temporary alternative solution to allow for referral to a tertiary care center. If the patient is septic or not fit for surgery, a percutaneous internal-external biliary drainage (PTBD) catheter can be placed until the patient's condition improves. We report a case of complete transection of the common hepatic duct during laparoscopic cholecystectomy managed by extra-anatomic PTBD.
腹腔镜胆囊切除术中医源性胆管损伤是一种已知的低发生率并发症。如果未能及时、妥善地识别和处理，后果可能是灾难性的。对于因胆囊切除术导致的医源性胆管损伤病例，处理方法取决于损伤的程度、发现的时间（术中或术后）以及患者的状况。如果在术中发现，应立即处理损伤。如果缺乏专业知识，带有外部胆管引流的手术引流管可提供一种临时替代解决方案，以便转诊至三级医疗中心。如果患者发生脓毒症或不适合手术，可放置经皮肝内外胆管引流（PTBD）导管，直到患者状况改善。我们报告一例在腹腔镜胆囊切除术中肝总管完全横断，经解剖外PTBD处理的病例。
