Diagnosis, treatment and prevention of biliary hemorrhage after percutaneous transhepatic choledochoscopic lithotomy
10.3760/cma.j.cn431274-20220412-00311
- VernacularTitle:经皮肝胆管穿刺碎石术胆道出血并发症的诊治与预防
- Author:
Jiayin LU
1
;
Shaoqiu CHEN
;
Chao JIANG
;
Xintian WANG
;
Chen CHEN
Author Information
1. 湖南师范大学附属第一医院（湖南省人民医院）肝胆外科，湖南省卫生健康委员会胆道疾病研究中心，长沙 410005
- Keywords:
Lithotripsy;
Punctures;
Bile ducts, intrahepatic;
Cholelithiasis;
Postoperative hemorrhage
- From:
Journal of Chinese Physician
2022;24(11):1616-1619,1624
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis, treatment and prevention of biliary hemorrhage after percutaneous transhepatic choledochoscopic lithotomy(PTCSL).Methods:Retrospective summary and analysis were made on 48 cases of PTCSL completed by the hepatobiliary surgery department of Hunan Provincial People′s Hospital (the First Affiliated Hospital of Hunan Normal University) from January 2016 to December 2020.Results:Biliary hemorrhage occurred in 3 cases after operation, of which 1 case was considered to have a small amount of biliary mucosa bleeding, and the bleeding was stopped after blood transfusion, hemostatic agents and appropriate fluid rehydration. In the other case, a small amount of blood oozing around the T-tube sinus canal was accompanied by a small amount of bloody fluid in the T-tube, which was considered to cause arterioles or venules accompanied by bile duct bleeding during sinus expansion during operation, and the bleeding stopped after compression. Another patient underwent a short time drainage of hemorrhagic fluid ≥100 ml in T tube 15 days after operation, and was prepared for interventional therapy while receiving blood transfusion products and conservative treatment. Celiac arteriography was performed, and pseudoaneurysm was found in the right anterior lobe of the liver. Embolization was performed later and the patient discharged 10 days after embolization.Conclusions:Biliary hemorrhage is one of the more common complications after PTCSL. Increasing the understanding of this complication provides a guarantee for the safety of surgery and has clinical significance for patients with accelerated postoperative recovery.
