经皮肝穿刺胆道引流治疗外伤后胆瘘
汪邵平,霍枫,张玉新,裴世强,广州军区总医院普通外科 广东省广州市 510010
项目负责人:汪邵平,510010,广东省广州市流花路111号,广州军区总医院普外科.victorwsp@163.net
电话:020-36224648 传真:020-36222203
收稿日期:2002-12-05 接受日期:2003-01-18
摘要
目的:探讨一条简单、有效治疗顽固性胆瘘的途径.
方法:7例顽固性胆瘘尝试行经皮肝穿刺胆道引流术(PTCD)，对胆道进行外引流.
结果:2例置管失败，5例成功实施PTCD后，造影发现3例伴肝门部、胆总管狭窄.置管引流后，经瘘管流出的胆汁量从200-600mL/d降为60-180mL/d，无并发症，胆瘘平均愈合时间11.4d. 8例保守治疗的胆瘘患者中，1例死亡，余7例平均病程49.8d.
结论:PTCD操作简单、安全，是治疗外伤后顽固性胆瘘的重要措施.
汪邵平,霍枫,张玉新,裴世强.经皮肝穿刺胆道引流治疗外伤后胆瘘. 世界华人消化杂志 2003;11(6):879-880
Sugiyama M, Izumisato Y, Abe N, Yamaguchi Y, Yamato T,Masaki T,Mori T, Atomi Y. Endoscopic biliary stenting
for treatment of bile leakage after hepaticresection. Hepatogastroenterology 2001;48:1579-1581
2 Shahrudin MD,Noori SM. Biloma and biliary fistula associated with hepatorrhaphy forliver injury.
Hepatogastroenterology 1997;44:519-521
3 Sharma AK.External biliary fistula. Trop Gastroenterol 2001;22:163-168
4 Bose SM, MazumdarA, Singh V. The role of endoscopic procedures in the management ofpostcholecystectomy
and posttraumatic biliary leak. Surg Today 2001;31:45-50
5 孙志为,付德庄,莫一我,金焰,朱秀芳,乔欧,张新俊.内镜鼻胆鼻胰管负压引流治疗术后胆瘘和胰瘘.世界华人消
化杂志 1999;7:361-362
6 黄洁夫.腹部外科学.第1版.北京: 人民卫生出版社, 2001:472-473
7 Kromer MU, MaierM, Benz CA, Martin WR, Adamek HE,Kohler B, Riemann JF. Bile duct stenosesand leakage
after cholecystectomy: endoscopicdiagnosis, therapy and treatment outcome. Z Gastroenterol 1996;34:167-172
8 Hunt JA,Gallagher PJ, Heintze SW, Waugh R, Shiel GR. Percutaneous microcoilembolization of intraperitoneal
intrahepatic and extrahepatic biliaryfistulas. Aust N Z J Surg 1997;67:424-427, http://www.100md.com( 汪邵平,霍 枫,张玉新,裴世强)
项目负责人:汪邵平,510010,广东省广州市流花路111号,广州军区总医院普外科.victorwsp@163.net
电话:020-36224648 传真:020-36222203
收稿日期:2002-12-05 接受日期:2003-01-18
摘要
目的:探讨一条简单、有效治疗顽固性胆瘘的途径.
方法:7例顽固性胆瘘尝试行经皮肝穿刺胆道引流术(PTCD)，对胆道进行外引流.
结果:2例置管失败，5例成功实施PTCD后，造影发现3例伴肝门部、胆总管狭窄.置管引流后，经瘘管流出的胆汁量从200-600mL/d降为60-180mL/d，无并发症，胆瘘平均愈合时间11.4d. 8例保守治疗的胆瘘患者中，1例死亡，余7例平均病程49.8d.
结论:PTCD操作简单、安全，是治疗外伤后顽固性胆瘘的重要措施.
汪邵平,霍枫,张玉新,裴世强.经皮肝穿刺胆道引流治疗外伤后胆瘘. 世界华人消化杂志 2003;11(6):879-880
Sugiyama M, Izumisato Y, Abe N, Yamaguchi Y, Yamato T,Masaki T,Mori T, Atomi Y. Endoscopic biliary stenting
for treatment of bile leakage after hepaticresection. Hepatogastroenterology 2001;48:1579-1581
2 Shahrudin MD,Noori SM. Biloma and biliary fistula associated with hepatorrhaphy forliver injury.
Hepatogastroenterology 1997;44:519-521
3 Sharma AK.External biliary fistula. Trop Gastroenterol 2001;22:163-168
4 Bose SM, MazumdarA, Singh V. The role of endoscopic procedures in the management ofpostcholecystectomy
and posttraumatic biliary leak. Surg Today 2001;31:45-50
5 孙志为,付德庄,莫一我,金焰,朱秀芳,乔欧,张新俊.内镜鼻胆鼻胰管负压引流治疗术后胆瘘和胰瘘.世界华人消
化杂志 1999;7:361-362
6 黄洁夫.腹部外科学.第1版.北京: 人民卫生出版社, 2001:472-473
7 Kromer MU, MaierM, Benz CA, Martin WR, Adamek HE,Kohler B, Riemann JF. Bile duct stenosesand leakage
after cholecystectomy: endoscopicdiagnosis, therapy and treatment outcome. Z Gastroenterol 1996;34:167-172
8 Hunt JA,Gallagher PJ, Heintze SW, Waugh R, Shiel GR. Percutaneous microcoilembolization of intraperitoneal
intrahepatic and extrahepatic biliaryfistulas. Aust N Z J Surg 1997;67:424-427, http://www.100md.com( 汪邵平,霍 枫,张玉新,裴世强)
