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首页> 外文期刊>Digestive Diseases and Sciences >Role of symptoms, trend of liver tests, and endotherapy in management of post-cholecystectomy biliary leak.
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Role of symptoms, trend of liver tests, and endotherapy in management of post-cholecystectomy biliary leak.

机译：症状，肝检趋势和内治疗在胆囊切除术后胆漏的处理中的作用。

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AIM: Biliary leaks are widely reported complications of cholecystectomy, but standard management remains undecided. The objective of our study was to report the role of symptoms, biochemical tests, and ERCP in patients with a leak. MATERIALS AND METHODS: Twenty-one patients (8 M, 26-77 years) with suspected post-cholecystectomy biliary leak were retrospectively studied. Symptoms and liver tests (LTs) after surgery were monitored. Trends of LTs were considered positive if increases at >48 h were seen. ERCP was performed in all patients. Findings at endoscopy and treatments were reported. Outcome results were obtained for all patients. RESULTS: Seventeen of 21 patients had persistent biliary leak at ERCP, because of direct injury (n = 10), accessory duct (n = 4), or cystic duct stump (n = 3). Eleven of 17 patients (six without symptoms), had distal obstruction because of surgical injury (n = 8), stone (n = 2), or cholangiocarcinoma (n = 1) and underwent stenting (n = 4), naso-biliary drainage, NBD (n = 3), or surgery (n = 4). Among the six patients without obstruction (four without symptoms), stenting was performed in two and NBD in four. The four patients without apparent leak underwent NBD. Impairment of LTs was present in ten out of eleven (91%) patients with obstruction versus six of ten (60%) without obstruction. No complications occurred after ERCP. During a median follow-up of 33 months (cholangiocarcinoma excluded) all but one remained asymptomatic. CONCLUSIONS: Symptoms and trend of LTs were not predictive of biliary obstruction in patients with a leak after cholecystectomy. Both endotherapy and surgery had favorable outcomes.
机译：目的：胆漏已被广泛报道为胆囊切除术的并发症，但标准治疗尚无定论。我们研究的目的是报告症状，生化检查和ERCP在渗漏患者中的作用。材料与方法：回顾性研究21例疑似胆囊切除术后胆漏的患者（8 M，26-77岁）。监测手术后的症状和肝脏检查（LT）。如果在> 48 h观察到LTs的趋势为阳性，则认为该趋势为阳性。所有患者均进行了ERCP。报告了内窥镜检查和治疗结果。获得了所有患者的结果。结果：21例患者中有17例由于直接伤害（n = 10），副导管（n = 4）或胆囊管残端（n = 3）在ERCP出现持续性胆漏。 17例患者中有11例（无症状）（6例），由于外科手术损伤（n = 8），结石（n = 2）或胆管癌（n = 1）远端梗阻并接受了支架置入术（n = 4），鼻胆管引流，NBD（n = 3）或手术（n = 4）。在6例无梗阻的患者中（4例无症状），在2例中进行了支架置入，在4例中进行了NBD。 4名无明显渗漏的患者接受了NBD。十一名梗阻患者中有十名（91％）LTs受损，而十名无梗阻患者中有六名（60％）存在LTs损伤。 ERCP术后无并发症发生。在33个月的中位随访期间（排除胆管癌），除1例外其余均无症状。结论：胆囊切除术后漏气的患者的LT的症状和趋势不能预示胆道梗阻。内治疗和手术均取得了良好的效果。

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