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腹腔镜胆囊切除术后患者胆囊管重复畸形致乳糜漏:1 例报告并文献复习。

Chyle leakage after laparoscopic cholecystectomy in a patient with duplicated cystic ducts: A case report and literature review.

机构信息

Department of General Surgery, Taicang Affiliated Hospital of Soochow University, Suzhou, P.R. China.

出版信息

Medicine (Baltimore). 2024 Oct 4;103(40):e39982. doi: 10.1097/MD.0000000000039982.

Abstract

RATIONALE

Laparoscopic cholecystectomy (LC) is widely performed as a standard treatment for cholelithiasis, and chyle leakage after LC has rarely been reported. Duplicated cystic ducts draining a single gallbladder is an extraordinarily rare variation.

PATIENT CONCERNS

We presented a case of chyle leakage after LC in a 53-year-old female with a rare variation of duplicated cystic ducts.

DIAGNOSES

Chyle leakage and duplicated cystic ducts.

INTERVENTIONS

Conservative treatment including lipid intake and constant drainage.

OUTCOMES

After 24 days of conservative treatment, the patient recovered and had no further troubles during the 3-month follow-up.

LESSONS

There may be a potential relationship between anatomic variants of the extrahepatic bile ducts and those of the lymphatic system. When anatomic variations of the extrahepatic bile ducts are encountered, vigilance for lymphatic system injuries is as important as vigilance for bile duct injuries. Conservative therapy is the first choice for postoperative chyle leakage, and surgical intervention should be considered in cases with high-volume chyle leakage.

摘要

背景

腹腔镜胆囊切除术(LC)被广泛应用于治疗胆石症,LC 术后乳糜漏很少见。单一胆囊存在两条胆囊管引流是一种非常罕见的变异。

病例介绍

我们报告了一例 53 岁女性 LC 术后乳糜漏病例,其存在罕见的双胆囊管变异。

诊断

乳糜漏和双胆囊管。

干预措施

包括脂质摄入和持续引流的保守治疗。

结果

经 24 天的保守治疗后,患者痊愈,在 3 个月的随访中无进一步问题。

结论

肝外胆管的解剖变异与淋巴系统之间可能存在一定的关系。当遇到肝外胆管的解剖变异时,对胆管损伤的警惕性与对胆管损伤的警惕性同样重要。术后乳糜漏的首选治疗方法是保守治疗,对于乳糜漏量大的病例应考虑手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6ae/11460926/edfcb34418f1/medi-103-e39982-g001.jpg

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