病例报告

鼻胆管改良胆道支架导致肝穿孔(附1例报告)

  • 矫元君 ,
  • 尹耀新 ,
  • 李桂贤 ,
  • 刘吉奎 ,
  • 林泽伟
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  • 北京大学深圳医院肝胆胰外科,广东 深圳 518036
林泽伟,E-mail:szlinzw@126.com

收稿日期: 2023-02-22

  网络出版日期: 2025-01-23

基金资助

深圳市科技计划项目(JCYJ20190809095011463)

Liver perforation caused by modified biliary stent of nasobiliary duct:a case report

  • JIAO Yuanjun ,
  • YIN Yaoxin ,
  • LI Guixian ,
  • LIU Jikui ,
  • LIN Zewei
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  • Department of Hepatobiliary and Pancreatic Surgery, Peking University Shenzhen Hospital,Guangdong Shenzhen 518036, China

Received date: 2023-02-22

  Online published: 2025-01-23

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。

本文引用格式

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 . DOI: 10.16139/j.1007-9610.2024.05.14

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.

参考文献

[1] PARK T Y, HONG S W, OH H C, et al. Colonic diverticular perforation by a migrated biliary stent: a case report with literature review[J]. Medicine(Baltimore), 2021, 100(52):e28392.
[2] KUMAR K, SINHA R, NAFE Z M. Post ERCP gastrointestinal hemorrhage: an unusual complication of migrated biliary stent[J]. J Family Med Prim Care, 2020, 9(2):1212-1214.
[3] CAI K L, WANG G B, TAO K X, et al. Role of ERCP in the treatment of bile leakage after cholecystectomy[J]. China J Endosc, 2004, 10(1):39-42.
[4] ZHOU W C, ZHANG H, LI X. Value of ERCP in the treatment of iatrogenic bile duct injury[J]. Chin J Pract Surg, 2017, 37(8):861-866.
[5] WARNER B, HARRISON P, FARMAN M. A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures[J]. BMC Gastroenterol, 2020, 20(1):329.
[6] GROMSKI M A, BICK B L, VEGA D, et al. A rare complication of ERCP: duodenal perforation due to biliary stent migration[J]. Endosc Int Open, 2020, 8(11):E1530-E1536.
[7] TAO Y, LONG J. Sigmoid colon perforation caused by migrated plastic biliary stents: a case report[J]. Int J Colorectal Dis, 2021, 36(1):199-201.
[8] PEREZ A R, DEL MUNDO H J F, VIRAY B A G, et al. Duodenal perforation secondary to stent migration after ERCP for hepatobiliary tuberculosis: case report of a lethal complication in a young patient[J]. Int J Surg Case Rep, 2021,88:106510.
[9] FIGUEIRAS R G, ECHART M O, FIGUEIRAS A G, et al. Colocutaneous fistula relating to the migration of a biliary stent[J]. Eur J Gastroen Hepat, 2001, 13(10):1251-1253.
[10] TZOVARAS G, LIAKOU P, MAKRYIANNIS E, et al. Acute appendicitis due to appendiceal obstruction from a migrated biliary stent[J]. Am J Gastroenterol, 2007, 102(1):195-196.
[11] AGHA R A, FRANCHI T, SOHRABI C, et al. The SCARE 2020 guideline: updating consensus surgical case report (SCARE) guidelines[J]. Int J Surg, 2020,84:226-230.
[12] PENGERM? P, KATUNIN J, TURUNEN A, et al. Appendiceal perforation due to biliary stent migration in a neutropenic patient with lung cancer receiving chemotherapy: a case report[J]. Mol Clin Oncol, 2021, 15(1):136.
[13] JADALLAH K, ALZUBI B, SWEIDAN A, et al. Intraperitoneal duodenal perforation secondary to early migration of biliary stent: closure with through-the-scope clip[J]. BMJ Case Rep, 2019, 12(9):e230324.
[14] MOHAMMAD ALIZADEH A H, DONBOLI K, KHODAKARAMI M, et al. Biliary stent migration to hepatic duct-case report of a late complication[J]. Clin Med Insights Case Rep, 2015,8:13-14.
[15] TSEMA I, SLOBODIANYK V, RAHUSHYN D, et al. Non-operative management of bronchobiliary fistula due to proximal migration of biliary stent in a patient with unresectable klatskin tumor[J]. Clin Med Insights Case Rep, 2021,14:11795476211043067.
[16] KATAKURA Y, ASAKI T, ADACHI S, et al. Late migration of covered metal stent to the stomach through a spontaneous choledochoduodenal fistula in a patient with malignant biliary obstruction[J]. Gastroenterol Res, 2012, 5(3):133-137.
[17] RICHENBERG J I, AMIN Z, HATFIELD A R, et al. Pleurobiliary fistula following Tannenbaum biliary stent insertion[J]. Eur Radiol, 1996, 6(5):697-699.
[18] AHMAD F, SAUNDERS RN, LLOYD GM, et al. An algorithm for the management of bile leak following laparoscopic cholecystectomy[J]. Ann R Coll Surg Engl, 2007, 89(1):51-56.
[19] COELHO-PRABHU N, BARON T H. Assessment of need for repeat ERCP during biliary stent removal after clinical resolution of postcholecystectomy bile leak[J]. Am J Gastroenterol, 2010, 105(1):100-105.
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