Kähler G, Müller C, al-Sibaie A, Scheele J
Abteilung für Allgemeine und Viszerale Chirurgie, Friedrich-Schiller-Universität Jena.
Zentralbl Chir. 1998;123 Suppl 2:96-7.
Biliary tract injury, although uncommon, is the most feared complication of laparoscopic cholecystectomy. Early identification or exclusion of such injury is essential for successful management. Over a two year period (1995-1996) twenty-one from a total of 413 ERCPs in this Surgical Endoscopy Unit were performed because of suspected biliary injury after laparoscopic cholecystectomy. 16 patients were referred from other units. No abnormality was demonstrated in two cases. A clip-related stenosis requiring reoperation was shown in twei patients. The remaining 17 cases had biliary leakage, related to an aberrant bile duct in 2 cases or a cystic duct leak in 15, all of which were treated endoscopically by nasobiliary tube (7), endoscopic papillotomy (5) or a combination of both (5). All of these biliary leaks healed uneventfully no ERCP-associated morbidity.
胆道损伤虽不常见,但却是腹腔镜胆囊切除术最可怕的并发症。早期识别或排除此类损伤对于成功治疗至关重要。在两年期间(1995 - 1996年),该外科内镜科室共进行了413例内镜逆行胰胆管造影(ERCP),其中21例是因腹腔镜胆囊切除术后怀疑有胆道损伤而进行的。16例患者是从其他科室转诊而来。2例未发现异常。2例显示与夹子相关的狭窄需要再次手术。其余17例有胆漏,其中2例与异常胆管有关,15例与胆囊管漏有关,所有这些均通过鼻胆管(7例)、内镜乳头切开术(5例)或两者联合(5例)进行内镜治疗。所有这些胆漏均顺利愈合,无ERCP相关的并发症。