Vu Phuong, Daneshvar Meelod, Chintanaboina Jayakrishna, Fathi Amir
Department of Surgery, University of California San Francisco, Fresno, CA 93701, United States.
Department of Gastroenterology and Hepatology, University of California San Francisco, Fresno, CA 93702, United States.
J Surg Case Rep. 2024 Feb 29;2024(2):rjae071. doi: 10.1093/jscr/rjae071. eCollection 2024 Feb.
Since the early 1990's, laparoscopic cholecystectomy has become the gold standard for the treatment of symptomatic gallbladder disease. Although the incidence of postoperative complications is generally lower with this approach, gallbladder perforation represents a serious risk that is among the most common complications of laparoscopic cholecystectomy. The sequalae that can follow iatrogenic perforation have not been well documented and only a few case reports exist in the current literature. In this paper we discuss two case reports of delayed perihepatic abscesses following prior laparoscopic cholecystectomy, ultimately resulting in fistulous tracts. The course of the disease is discussed along with the diagnostic workup and eventual successful management of the aforementioned complications. Treating enteric fistulae requires a systematic approach and is carried out in phases. Enteric fistula formation following laparoscopic cholecystectomy is a rare complication of retained gallstones that can present months to years following the index operation. Significant care should be taken to avoid perforation and all efforts should be made to retrieve stones if spillage occurs.
自20世纪90年代初以来，腹腔镜胆囊切除术已成为治疗有症状胆囊疾病的金标准。虽然这种方法术后并发症的发生率总体较低，但胆囊穿孔是腹腔镜胆囊切除术最常见并发症之一的严重风险。医源性穿孔后的后遗症尚未得到充分记录，目前文献中仅有少数病例报告。在本文中，我们讨论两例先前腹腔镜胆囊切除术后延迟性肝周脓肿的病例报告，最终导致瘘管形成。本文还讨论了疾病的病程、诊断检查以及上述并发症的最终成功处理。治疗肠瘘需要系统的方法，且分阶段进行。腹腔镜胆囊切除术后肠瘘形成是残留胆结石的罕见并发症，可在初次手术后数月至数年出现。应格外小心避免穿孔，一旦发生结石溢出，应尽一切努力取出结石。
