鼻胆管改良胆道支架导致肝穿孔（附1例报告）

doi:10.16139/j.1007-9610.2024.05.14

摘要/Abstract

摘要：

胆道支架发生移位的病例很多，一般是向远端移位，发生近端移位的病例罕见。我们报道1例49岁女性，在接受机器人辅助右半肝切除术后发生胆漏，从而留置胆道支架。病人胆漏痊愈后出院，5个月后复查发现胆道支架向肝内移位并导致肝脏穿孔。笔者利用取石球囊及圈套器将支架完整取出。笔者建议留置胆道支架时需考虑使用长度适中的支架，并告知病人返院拔除支架的时间，避免支架发生移位而发生并发症。

关键词: 内镜逆行胰胆管造影术, 胆漏, 胆道支架, 并发症

Abstract:

There are many cases of biliary stent migration. Generally, biliary stent migrates distally. While, biliary stent rarely migrates proximally. Here we reported the case of a 49-year-old woman who underwent robot assisted right hemihepatectomy, and placement of a biliary stent for complicating bile leakage. The patient was discharged from hospital after recovering from bile leakage. Five months later, a follow-up examination revealed that the biliary stent had shifted into the liver, leading to liver perforation. We fully removed the stent by using a stone retrieval balloon and a snare. We suggested that when useing a biliary stent, it is necessary to consider of appropriate length of the stent and inform the patient when to return to the hospital for stent removal, in order to avoid stent migration and complications occurrence.

Key words: Endoscopic retrograde cholangio-pancreatography, Bile leakage, Biliary stent, Complication

中图分类号:

矫元君, 尹耀新, 李桂贤, 刘吉奎, 林泽伟. 鼻胆管改良胆道支架导致肝穿孔（附1例报告）[J]. 外科理论与实践, 2024, 29(05): 452-454.

JIAO Yuanjun, YIN Yaoxin, LI Guixian, LIU Jikui, LIN Zewei. Liver perforation caused by modified biliary stent of nasobiliary duct：a case report[J]. Journal of Surgery Concepts & Practice, 2024, 29(05): 452-454.

图/表 2

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Inspection indicators	Preoperative	Postoperative
Leukocyte（×10⁹/L）	4.26	5.48
Neutrophil ratio（%）	66.8	67.9
Hemoglobin（g/L）	129	118
Glutamic-pyruvic transaminase（U/L）	39	27
Total bilirubin（μmol/L）	9.5	17.3
Blood albumin（g/L）	46.4	36.8
Blood potassium（mmol/L）	4.26	4.02
Blood sodium（mmol/L）	140	139