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腹腔镜胆囊切除术后胆囊管残余-十二指肠瘘:一例报告及文献复习

Cystic Duct Remnant-Duodenal Fistula following Laparoscopic Cholecystectomy: A Case Report and Literature Review.

作者信息

Polikarpova Aleksandra, Lau Ngee-Soon, Yeo David

机构信息

Department of Upper Gastrointestinal and Hepatobiliary Surgery, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia.

Institute of Academic Surgery, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW 2050, Australia.

出版信息

Reports (MDPI). 2024 Feb 23;7(1):16. doi: 10.3390/reports7010016.

Abstract

Laparoscopic cholecystectomy is the most common procedure performed for the management of symptomatic gallstone disease. This, however, can be complicated by the formation of fistulous communications between the biliary tree and the gastrointestinal tract. This abnormal communication allows for the flow of bile and bowel contents between two systems (biliary system and intestine), which can cause abdominal pain, nausea, vomiting, and biliary sepsis. We would like to present a rare case of fistulous communication between the cystic duct stump and duodenum and outline possible contributing factors. The literature review describes the most common interventions for the management of fistulas with emphasis on ERCP and stent preferences to eliminate transpapillary pressure gradient, which directly contributes to fistula closure.

摘要

腹腔镜胆囊切除术是治疗有症状胆结石疾病最常用的手术。然而,这可能会因胆道系统与胃肠道之间形成瘘管而变得复杂。这种异常连通使得胆汁和肠内容物在两个系统(胆道系统和肠道)之间流动,可导致腹痛、恶心、呕吐和胆源性败血症。我们想呈现一例胆囊管残端与十二指肠之间瘘管连通的罕见病例,并概述可能的促成因素。文献综述描述了治疗瘘管的最常见干预措施,重点是内镜逆行胰胆管造影术(ERCP)和支架选择,以消除经乳头压力梯度,这直接有助于瘘管闭合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d1d/12225490/dbf986335fc4/reports-07-00016-g001.jpg

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