[经内镜逆行胰胆管造影术（ERCP）、内镜乳头括约肌切开术（EPT）及胆管引流术治疗腹腔镜胆囊切除术后胆瘘]
[Treatment of postoperative bile fistulas after laparoscopic cholecystectomy by ERCP, EPT and bile duct drainage].
作者信息
Holzinger J, Mayer F, Heinerman P M, Sungler P, Waclawiczek H W, Boeckl O
机构信息
I. Chirurgische Klinik.
出版信息
Zentralbl Chir. 1997;122(12):1088-91.
BACKGROUND
Bile leakage as a complication following cholecystectomy can be found more frequently after laparoscopic cholecystectomy (LC) than after open cholecystectomy. The present study planned to find out the importance of ERCP, sphincterotomy and temporary drainage of the bile duct system in the treatment of bile leakage.
PATIENTS AND METHODS
From July 1992 to October 1996 15 consecutive patients presenting with bile leakage following LC underwent endoscopic therapy by CBD-drainage with sphincterotomy (n = 11), CBD-drainage without sphincterotomy (n = 1) and sphincterotomy alone (n = 3).
RESULTS
Closure of the bile leakage could be achieved in all cases, biliary secretion stopped after 2.1 days (1-7 days). One dislocation of the drainage into the CBD was found and could be treated endoscopically. Endoscopy-related mortality was 0%.
CONCLUSIONS
Endoscopic therapy offers a safe, effective and minimal invasive method in the treatment of bile leakage following LC.
背景
胆囊切除术后胆漏作为一种并发症，在腹腔镜胆囊切除术（LC）后比开腹胆囊切除术后更常见。本研究旨在明确内镜逆行胰胆管造影（ERCP）、括约肌切开术及胆管系统临时引流在治疗胆漏中的重要性。
患者与方法
1992年7月至1996年10月，15例LC术后出现胆漏的连续患者接受了内镜治疗，其中11例行胆管引流联合括约肌切开术，1例行胆管引流但未行括约肌切开术，3例行单纯括约肌切开术。
结果
所有病例的胆漏均得以闭合，胆汁分泌在2.1天（1 - 7天）后停止。发现1例引流管移位至胆总管，可通过内镜治疗。内镜相关死亡率为0%。
结论
内镜治疗为LC术后胆漏的治疗提供了一种安全、有效且微创的方法。
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