Schilling D, Zöpf T, Adamek H E, Riemann J F
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH, Ludwigshafen.
Zentralbl Chir. 1998;123 Suppl 2:84-8.
Minimal invasive methods compete with surgical treatment in the therapy of complications after cholecystectomy. We demonstrate our results of endoscopic therapy. 52 patients with postoperative complications (39 stenoses, 5 leakages, 6 stenoses and leakages, 2 complete obliterations of bile duct) were treated by transpapillary or transhepatic biliary drainage over a time period of 12 months. In 73% of patients who completed the therapy protocol successful treatment was possible. In 4 cases a restenosis occurred. 4 patients underwent surgical treatment. We think endoscopic management is the therapy of first choice for postoperative biliary complications. Biliary stricture should be dilatated for 12 months by biliary endoprosthesis, leakage can be drained for shorter time periods.
在胆囊切除术后并发症的治疗中，微创方法与手术治疗相互竞争。我们展示了内镜治疗的结果。在12个月的时间里，对52例术后并发症患者（39例狭窄、5例渗漏、6例狭窄合并渗漏、2例胆管完全闭塞）进行了经乳头或经肝胆汁引流治疗。在完成治疗方案的患者中，73%的患者获得了成功治疗。有4例发生了再狭窄。4例患者接受了手术治疗。我们认为内镜治疗是术后胆道并发症的首选治疗方法。胆管狭窄应通过胆道内支架扩张12个月，渗漏可在较短时间内引流。
