Buradasınız

Safra Yolu Yaralanmalarının Perkütan Biliyer Drenaj İle Tedavisi

Treatment of Bile Duct İnjuries By Percutaneous Biliary Drainage

Journal Name:

Publication Year:

Abstract (2. Language): 
Causes of bile duct injuries are usually iatrogenic. It occurs as a complication of hepatobiliary surgery especially the laparoscopic cholecystectomy. The surgical treatment of bile duct injuries is often difficult and limited. Therefore the least invasive technique for the treatment is to place a biliary catheter or a temporary plastic stent. In our study, the results of sixteen patients who were diagnosed as having bile duct injury and then treated with radiologic techniques are presented and discussed. In all patients, peritoneal fluid collection was drained through percutaneous catheter, and percutaneous biliary drainage was also performed. Biliary drainage catheters were left in place for 15-50 days (mean 28 days) Patients were followed up for 5-90 months (mean 44 months). Fourteen of sixteen patients were healed completely after radiologic treatment. Two patients were referred to surgery. Percutaneous biliary drainage is effective technique for treatment of bile duct injuries and it usually provides complete healing.
Abstract (Original Language): 
Safra yolu yaralanmaları genellikle iatrojenik nedenlidir. Başta laporoskopik kolesistektomi olmak üzere hepatobiliyer cerrahinin komplikasyonu olarak görülür. Safra yolu yaralanmalarının tedavisinde cerrahi olarak yapılabilecekler sınırlı ve zordur. Bu nedenle tedavi için en az invaziv yöntem safra yolunun kateterizasyonu veya geçici olarak plastik stent yerleştirilmesidir. Çalışmamızda 8 yıllık dönemde Uludağ Üniversitesi Tıp Fakültesi Radyoloji Anabilim dalında safra yolu yaralanması saptanan ve radyolojik yöntemlerle tedavi edilen 16 olgu sunularak tartışılmıştır. Olgularda peritona sızan safra perkütan kateter drenajı ile drene edildi ve perkütan biliyer drenaj uygulandı. Biliyer drenaj kateterleri 15-50 gün arasında (ortalama 28 gün) tutuldu. Olgular ortalama 44 ay (5-90 ay) izlendi. 16 hastadan 14’ü radyolojik yöntemlerle tamamen tedavi edildi. İki olguya cerrahi operasyon önerildi. Perkütan biliyer drenaj safra kaçağına neden olan yaralanmaların primer tedavisinde, etkin bir yöntemdir. Genellikle tam iyileşme sağlamaktadır.
1-5

REFERENCES

References: 

1. Liguory C, Vitale GC, Lefebre JF, BonnelD, Cornud F.
Endocopic treatment of postopertive biliary fistulae. Surgery
1991; 110: 779-784
2. Feliciano DV, Bitondo CG, Burch JM, et al. Management of
traumatic injuries to the extrahepatic biliary ducts. Am J Surg
1985; 150: 705–709.
3. Wright TB, Bertino RB, Bishop AF. Complications of
laparoscopic cholecystectomy and their interventional
radiologic management. RadioGraphics 1993; 13: 119-128
4. Slanetz PJ, Boland GW, Mueller PR. Imaging and
interventional radiology in laparoscopic injuries to the
gallbladder and biliary system. Radiology 1996; 201: 595–
603.
5. Rantis PC, Greenlee HB, Pickleman J, et al. Laparoscopic
cholecystectomy bile duct injuries: more than meets the eye.
Am Surg 1993; 59: 533–540.
6. Van Sonnenberg E, Casola G, Wittich GR, et al. The role of
interventional radiology for complications of cholecystecomy. Surgery 1990; 107: 632–638.
7. Lillemoe KD, Martin SA, Cameron JL, et al. Major bile duct
injuries during laparoscopic cholecystectomy. Ann Surg 1997;
225: 459–471.
8. Ernst O, Sergent G, Mizrahi D, Delemazure O, L’Hermine C.
Biliary leaks: treatment by means of percutaneous transhepatic
biliary drainage. Radiology 1999; 211: 345-348
9. McGahan JP, Stein M. Complications of laparoscopic
cholecystectomy: İmaging and intervention. AJR Am J
Roentgenol 1995; 165: 1089–1097.
10. Kozarek RA. Endoscopic techniques in management of biliary
tract injuries. Surg Clin North Am 1994; 74: 883–893.
11. Dowsett JF, Vaira D, Hatfield ARW, et al. Endoscopic biliary
therapy using the combined percutaneous and endoscopic
technique. Gastroenterology 1989; 96: 1180–1186.
12. Dawson SL, Zerbey Al, Mueller PR. Radiologic management
of laparoscopic bile duct injuries. Semin Intervent Radiol
1996; 13: 45–54.
13. Dawson SL, Mueller PR. Interventional radiology in the
management of bile duct injuries. Surg Clin North Am 1994;
74: 865–874.

Thank you for copying data from http://www.arastirmax.com