PDF(Pubmed)
Abstract：
Iatrogenic bile duct injury during laparoscopic cholecystectomy is a known complication of low incidence. The outcome can be devastating if not recognized and managed timely and properly. In cases of iatrogenic biliary injury due to cholecystectomy, the management depends on the level of injury, the timing of discovery (intraoperative or postoperative), and the patient\'s condition. If discovered intraoperatively, the injury should be managed immediately. In case expertise is lacking, a surgical drain with external biliary drainage can provide a temporary alternative solution to allow for referral to a tertiary care center. If the patient is septic or not fit for surgery, a percutaneous internal-external biliary drainage (PTBD) catheter can be placed until the patient\'s condition improves. We report a case of complete transection of the common hepatic duct during laparoscopic cholecystectomy managed by extra-anatomic PTBD.
摘要：
腹腔镜胆囊切除术中医源性胆管损伤是一种发生率低的已知并发症。如果不及时和适当地认识和管理，结果可能是毁灭性的。在由于胆囊切除术引起的医源性胆道损伤的情况下，管理层取决于受伤的程度，发现的时机（术中或术后），和病人的情况。如果在术中发现，受伤应立即处理。如果缺乏专业知识，带外部胆道引流的外科引流可以提供临时替代解决方案，以允许转诊到三级护理中心。如果病人是败血症或不适合手术，可放置经皮内外胆道引流（PTBD）导管，直至患者病情好转。我们报告了一例由解剖外PTBD管理的腹腔镜胆囊切除术中总肝管完全横切的病例。
