ID | 32112 |
JaLCDOI | |
フルテキストURL | |
著者 |
Ota, Tetsuya
Okayama University
Hirai, Ryuji
Okayama Red Cross Hospital
Murakami, Masakazu
Okayama University
Naitou, Minoru
Okayama University
Shimizu, Nobuyoshi
Okayama University
|
抄録 | We report a case requiring biliary reconstruction with right hepatic lobectomy due to biliary strictures caused by continuous cholangitis after laparoscopic bile duct injury. The patient, a 55-year-old woman, underwent laparoscopic cholecystectomy for cholelithiasis at another hospital. Although a bile leakage from the intraabdominal drain was observed several days after the operation, the patient was not given adequate treatment to stop the leakage. Two months after the initial laparoscopic cholecystectomy, she was referred to our hospital. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete obstruction of the common hepatic duct, which was caused by clipping during laparoscopic cholecystectomy. Cholangiography from percutaneous transhepatic biliary drainage (PTBD) catheters revealed that sections of the secondary branches of the right intrahepatic bile duct had become constricted due to persistent cholangitis. Fortunately, the left hepatic duct was judged to be normal by imaging. Therefore, we elected to perform a right hepatic lobectomy and left hepaticojejunostomy, because we felt that performing a hepaticojejunostomy without hepatic resection would put the patient at risk of continuing to suffer from cholangitis. The patient was discharged on the 55 th postoperative day, and, 5 years after reconstructive surgery, is healthy and has remained free from biliary strictures in the remnant liver. Appropriate decision-making is essential in the treatment of biliary injury after laparoscopic cholecystectomy. Surgeons should not hesitate to perform biliary reconstruction with hepatic resection to reduce the risk of cholangitis or biliary strictures of the remnant liver. More importantly, preoperative clear imaging of the biliary tree and suitable management of any biliary injury which might occur are necessary to avoid having to perform reconstructive surgery. |
キーワード | ?biliary injury
laparoscopic cholecystectomy
hepatic resection
|
Amo Type | Article
|
出版物タイトル |
Acta Medica Okayama
|
発行日 | 2004-06
|
巻 | 58巻
|
号 | 3号
|
出版者 | Okayama University Medical School
|
開始ページ | 163
|
終了ページ | 167
|
ISSN | 0386-300X
|
NCID | AA00508441
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資料タイプ |
学術雑誌論文
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言語 |
英語
|
論文のバージョン | publisher
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査読 |
有り
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PubMed ID | |
Web of Science KeyUT |