Kuntz H D, John S, May B, Meessen D
Leber Magen Darm. 1983 Jan;13(1):33-6.
Intraoperative lesions of the extrahepatic bile ducts during cholecystectomy do occur; the incidence is about 0.2 to 0.8%. Lesions of the hepatic duct and the choledochus duct followed by stenosis (usually of the cystic duct confluent) do occur most frequently. Intraoperative ligation of the hepatic duct or the choledochus duct are the most severe sequelae of biliary surgery; the leading symptom is progressive postoperative obstructive jaundice. A bilio-digestive fistula may be formed spontaneously and may masquerade this complication leading to relapsing cholangitis. Pathogenesis, clinical symptoms and therapy of bilio-digestive fistula are discussed, after an own case report is given.
胆囊切除术期间肝外胆管的术中损伤确实会发生;发生率约为0.2%至0.8%。肝管和胆总管损伤继以狭窄(通常是胆囊管汇合处狭窄)最为常见。肝管或胆总管的术中结扎是胆道手术最严重的后遗症;主要症状是术后进行性梗阻性黄疸。胆肠瘘可能自发形成,可能掩盖这种并发症,导致复发性胆管炎。在给出一例自身病例报告后,讨论胆肠瘘的发病机制、临床症状和治疗。