腹腔镜胆囊切除术后迟发性胆漏2例(国外英文资料).docVIP

腹腔镜胆囊切除术后迟发性胆漏2例 Delayed biliary leakage after laparoscopic cholecystectomy: report of 2 cases This article source: paper / Keywords: laparoscopic cholecystectomy; delayed bile leakage; Delayed bile leakage is a rare complication after laparoscopic cholecystectomy, which is different from bile leakage in the early postoperative period. In this paper, 2 cases of delayed bile leakage after laparoscopic cholecystectomy were analyzed, and the causes and prevention measures were analyzed. 1 case data Case 1: patient, female, 42. He was admitted for 2 days because of right upper abdominal pain accompanied by nausea and vomiting. Laparoscopic cholecystectomy was performed 2 weeks ago. Physical examination: the upper abdomen slightly bulging, abdominal tenderness, rebound pain and muscle tension, right upper quadrant, moving turbid sound (+), weak bowel sounds. Diagnostic abdominal paracentesis, extraction, golden yellow bile. B Ultrasound suggests peritoneal effusion. Before admission, emergency laparotomy was performed. Through the right subcostal oblique incision. See: intraoperative intraperitoneal bile is about 1500ml, right upper abdominal adhesions, gallbladder bed, hepatoduodenal ligament edema, cystic duct stump clipping completely, no bile leakage, right hepatic duct wall defect, a flat oval, about 2cm * 0.8cm, edge necrosis. The Roux-en-Y end to side anastomosis of the hepatic duct jejunum was performed, and the abdominal cavity, the venturi cavity and the rectum and the uterus sunken cavity were respectively placed with the abdominal drainage tube 1. The abdominal drainage tube was removed 7 days after operation and the T tube was removed 3 months later. Postoperative follow-up showed that reflux cholangitis occurred occasionally. Case 2: patient, male, 40. 2H was admitted to the hospital for 10 days after cholecystectomy. Physical examination: right upper abdominal tenderness, no rebound pain and muscle tension, moving dullness (-). B Ultrasound suggests that