罕见胆管变异1例报道
Chinese Journal of Bases and Clinics in General Surgery（2008）
Abstract
患者,男,37岁,因"发现胆囊息肉1年"入院.B超检查见胆囊颈部息肉,直径约1.5 cm. 遂行腹腔镜胆囊切除、腹腔引流术,手术顺利.术后第3 d出现腹痛、腹胀及低热,无黄疸,肝功能正常,引流管无液体流出,B超检查提示肝下见5 cm×6 cm不规则液性暗区,考虑出血,给予止血、抗炎、对症治疗,腹痛、腹胀仍逐渐加重.术后第10 d行剖腹探查,术中发现右肝下血凝块约50 g,未见胆汁,行血肿清除、缝合止血、腹腔引流术.术后腹腔引流量逐渐减少, 4 d后再次出现腹痛、腹胀及低热,B超检查提示肝下积液,2 d内2次穿刺分别抽出黄绿色腹腔液约350 ml,考虑胆汁漏.于B超定位下穿刺留置引流管,引流出胆汁250~400 ml/d,腹痛、腹胀及发热减轻.
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