Nuñez D, Becerra J L, Martin L C
Department of Radiology, University of Miami School of Medicine, Jackson Memorial Hospital, Florida.
Abdom Imaging. 1994 May-Jun;19(3):248-50. doi: 10.1007/BF00203518.
Ten patients with subhepatic fluid collections complicating laparoscopic cholecystectomy were successfully treated by interventional radiological procedures. The series included five abscesses, three hematomas, one biloma, and one serous collection. Abdominal pain or fever developed from 3 to 21 days after the laparoscopic intervention. All patients were asymptomatic 72 h after percutaneous drainage and there were no complications related to the procedure. Subhepatic fluid accumulations are common findings after laparoscopic cholecystectomies and have been considered an unreliable indicator of infection or other postoperative complications. However, the significance of these collections should not be underestimated in symptomatic patients. In such cases we propose diagnostic aspiration and drainage, when necessary, to safely and promptly establish the precise diagnosis and treatment. More serious complications can be avoided by early percutaneous intervention.
10例腹腔镜胆囊切除术后并发肝下积液的患者通过介入放射学方法成功治愈。该系列包括5例脓肿、3例血肿、1例胆汁瘤和1例浆液性积液。腹痛或发热出现在腹腔镜干预后3至21天。所有患者在经皮引流72小时后均无症状，且未出现与该操作相关的并发症。肝下积液是腹腔镜胆囊切除术后的常见表现，一直被认为是感染或其他术后并发症的不可靠指标。然而，对于有症状的患者，这些积液的重要性不应被低估。在这种情况下，我们建议在必要时进行诊断性穿刺和引流，以安全、迅速地明确诊断并进行治疗。早期经皮介入可避免更严重的并发症。
