The Role of Endoscopic Procedures in the Management of Postcholecystectomy and Posttraumatic Biliary Leak
The Role of Endoscopic Procedures in the Management of Postcholecystectomy and Posttraumatic Biliary Leak
复制标题
内窥镜手术在胆囊切除术后和创伤后胆漏治疗中的作用
DOI：
10.1007/s005950170219
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发表时间：
2001
期刊：
影响因子：
2.5
通讯作者：
Virendra Singh
中科院分区：
文献类型：
--
作者：
S. Bose;A. Mazumdar;Virendra Singh
内镜逆行胰胆管造影术（ERCP）是评价胆道系统的重要工具。它不仅可以诊断胆管损伤后胆漏的部位，而且还可以作为一种治疗方式，允许进行介入手术，如括约肌切开术、鼻胆管引流或支架置入术。本研究旨在评价内镜治疗肝外伤或胆囊切除术后胆漏的作用。在21例肝外伤和胆道手术后发生胆漏的患者中，20例采用各种内镜手术治疗。在胆囊切除术后组中，ERCP显示9例胆囊管漏，6例胆总管损伤。2例患者仅通过括约肌切开术、4例患者仅通过鼻胆引流、8例患者通过括约肌切开术和鼻胆引流、1例患者通过括约肌切开术和支架放置来治疗这些并发症。五位外伤性胆瘘的病人均成功地接受了括约肌切开术及鼻胆管引流术。
Endoscopic retrograde cholangiopancreatography (ERCP) is an important tool in the evaluation of the biliary system. It not only diagnoses the site of biliary leak following bile duct injury, but it also acts as a therapeutic modality to allow interventional pro-cedures such as sphincterotomy, nasobiliary drainage, or stent placement to be performed. The present study was carried out to evaluate the role of endoscopic management of biliary leak, following either liver trauma or cholecystectomy. Of a total 21 patients with bile leak following liver trauma and biliary surgery, 20 were managed by various endoscopic procedures. In the postcholecystectomy group, ERCP revealed a cystic duct leak in 9 patients and common bile duct injury in 6 patients. These complications were managed by sphincterotomy alone in 2 patients, by nasobiliary drainage alone in 4 patients, by sphincterotomy and nasobiliary drainage in 8 patients, and by sphincterotomy and stent placement in 1 patient. Posttraumatic biliary fistula was successfully managed by performing sphincterotomy followed by the placement of nasobiliary drainage in all of five patients who had suffered trauma injury.