胆管探查术后肝脓肿利用内镜技术引流 1 例

本文回顾一例胆道手术后形成肝脓肿的患者,该患者为49岁女性,肝左叶切除+胆总管探查术后出现原因不明的持续高烧、高胆红素血症。影像学检查提示肝右叶肝脓肿、局部胆道闭塞。经过大剂量抗生素治疗以及经皮肝穿刺引流术(PTCD)治疗无效后给予急诊行内镜逆行胰胆管造影(ERCP)和内镜鼻胆管引流术(ENBD)脓肿引流,结果疗效显著,患者一周后症状明显好转。提示ERCP和ENBD内镜技术可早期解决由于术后局部闭塞性胆道梗阻引起肝脓肿。

Endoscopic drainage of liver abscess after bile duct exploration:A report of 1 case

This article reviewed a case of hepatic abscess following biliary surgery.This patient is a 49-year-old woman with persistent high fever and hyperbilirubinemia due to unexplained postoperative hepatic left lobectomy and common bile duct exploration.Imaging examination revealed liver abscess of the right lobe and local biliary obstruction.After high-dose antibiotic treatment and percutaneous transhepatic puncture drainage(PTCD)treatment failed,endoscopic retrograde cholangiopancreatography(ERCP)and endoscopic nasobiliary drainage(ENBD)drainage of the abscess was performed.The symptoms improved markedly.It is suggested that the endoscopic technique of ERCP and ENBD can resolve the liver abscess caused by obstruction of the biliary obstruction after operation.