Bile Duct Leaks from the Intrahepatic Biliary Tree A Review of Its Etiology, Incidence, and Management英文文献资料.docVIP

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Bile Duct Leaks from the Intrahepatic Biliary Tree A Review of Its Etiology, Incidence, and Management英文文献资料.doc

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Bile Duct Leaks from the Intrahepatic Biliary Tree A Review of Its Etiology, Incidence, and Management英文文献资料

HindawiPublishingCorporation HPBSurgery Volume2012,ArticleID752932,9pages doi:10.1155/2012/752932 ReviewArticle BileDuctLeaksfromtheIntrahepaticBiliaryTree:AReviewof ItsEtiology,Incidence,andManagement SorabhKapoorandSamiranNundy DepartmentofSurgicalGastroenterologyandLiverTransplantation,SirGangaRamHospital,NewDelhi110060,India CorrespondenceshouldbeaddressedtoSorabhKapoor,sorabhkapoor@ Received31December2011;Revised6February2012;Accepted19February2012 AcademicEditor:VitoR.Cicinnati Copyright?2012S.KapoorandS.Nundy.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Bileleaksfromtheintrahepaticbiliarytreeareanimportantcauseofmorbidityfollowinghepaticsurgeryandtrauma.Despite reductioninmortalityforhepaticsurgeryinthelast2decades,bileleaksrateshavenotchangedsigni?cantly.Inadditiontoposted operativebileleaks,leaksmayoccurfollowingdrainageofliverabscessandtumorablation.Mostbileleaksfromtheintrahepatic biliarytreearetransientandmanagedconservativelybydrainagealoneorendoscopicbiliarydecompression.Selectedcasesmay requirereoperationandentericdrainageorliverresectionformanagement. 1.Introduction (1)bile discharge from an abdominal wound and/or drain, with a total bilirubin level of 5mg/mL or threetimestheserumlevel, Bileleaksmainlyresultfrominjurytotheextrahepaticbile duct during cholecystectomy [1–3]. A bile leak from the intrahepaticbiliarytreeislessfrequentandgenerallyfollows liversurgeryandafterbluntorpenetratingabdominaltrau- ma[4–6].Lesscommonly,bileleaksfromthelivermayresult followingdrainageofaliverabscessornonsurgicalablation ofliverlesions.Themajorityofleaksaretransientandresolve spontaneously or after nonsurgical interventions like en- doscopic retrograde cholangiography and pancreatography (ERCP)with sphincterotomyand/orstenting[6–8].Afew willneedoperativecorrection.However,theseintrahepatic bileductleaksresultinsigni?cantpat