Abstract:
Cholecystectomy-related iatrogenic biliary injuries cause intricate postoperative complications that can significantly affect a patient\'s life, often leading to chronic liver disease and biliary stenosis. These patients require a multidisciplinary approach with intervention from radiologists, endoscopists and surgeons experienced in hepatobiliary reconstruction. Symptoms vary from none to jaundice, pruritus and ascending cholangitis. The best strategy for the management of biliary stricture is based on optimal preoperative planning. Our patient presented 1 year after an iatrogenic lesion was induced during a cholecystectomy, and was managed with a complex common bile duct reconstruction through a Roux-en-Y hepaticojejunostomy. The three-dimensional (3D) model reconstruction of the biliary tract was pivotal in the planning of the patient\'s surgery, providing additional preoperative and intraoperative assistance throughout the procedure. The 3D model\'s description of detailed spatial relations between the bile duct and the vascular structure in the liver hilum enabled a correct surgical dissection and safe execution of the anastomosis.
摘要:
胆囊切除术相关的医源性胆道损伤引起复杂的术后并发症,可显著影响患者的生活,常导致慢性肝病和胆道狭窄。这些患者需要放射科医生的多学科干预,内镜医师和外科医生在肝胆重建方面经验丰富。症状从无症状到黄疸,瘙痒和上行性胆管炎。治疗胆道狭窄的最佳策略是基于最佳的术前计划。我们的患者在胆囊切除术中引起医源性病变1年后出现,并通过Roux-en-Y肝空肠吻合术进行了复杂的胆总管重建。胆道的三维(3D)模型重建在患者的手术计划中至关重要,在整个手术过程中提供额外的术前和术中辅助。3D模型描述了胆管和肝门血管结构之间的详细空间关系,从而可以进行正确的手术解剖和安全的吻合。