Safra yolu yaralanmalarının perkütan biliyer drenaj ile tedavisi
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Date
2003-01-30
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Uludağ Üniversitesi
Abstract
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.
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.
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.
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Keywords
Safra yolu, Yaralanma, Perkütan biliyer, Drenaj, Bile duct, Percutaneous biliary, The injury
Citation
Sadıkoğlu, M. Y. vd. (2003). ''Safra yolu yaralanmalarının perkütan biliyer drenaj ile tedavisi''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 29(1), 1-5.