医源性肝包膜下胆汁瘤的临床及 CT 表现  

Clinical and CT manifestations of iatrogenic hepatic subcapsular biloma

作　　者：陈欣[1] 张宏[2] 戴社教[3] 杨全新[1] 

机构地区：[1] 西安交通大学第二附属医院 放射科,陕西 西安,710004 [2] 西安交通大学第二附属医院 住院医师规范化培训学员,陕西 西安,710004 [3] 西安交通大学第二附属医院 消化科,陕西 西安,710004

出　　处：《实用放射学杂志》2016年第8期1226-1229,共4页Journal of Practical Radiology

摘　　要：目的：探讨医源性肝包膜下胆汁瘤（HSB）的临床及 CT 表现。方法收集本院资料齐全、经穿刺确诊的医源性 HSB 患者7例,检索文献报道的医源性 HSB 病例18例,对其临床及 CT 表现特点进行回顾性分析。结果25例医源性 HSB 中,发生于腹腔镜胆囊切除术后9例,经皮经肝胆道引流术后5例,经皮经肝胆道取石术后4例,开腹胆囊切除术后2例,其他手术5例。CT 表现为肝脏包膜下水样密度影,局限性或弥漫性分布,呈新月形或囊袋状,部分病例伴有肝脏体积缩小,肝表面受压凹陷。结论肝胆手术,特别是腹腔镜及介入手术后,CT 显示肝脏包膜下局限性或弥漫性积液,应考虑 HSB 可能,需及早穿刺确诊并置管引流。Objective To investigate the clinical and CT manifestations of iatrogenic hepatic subcapsular biloma （HSB）.Methods Seven cases with iatrogenic HSB confirmed by paracentesis in our hospital,and 18 reported in literatures were enrolled into this study.Their clinical and CT manifestations were retrospectively analyzed.Results Of the 25 cases,9 were secondary to laparoscopic cholecystectomy （LC）,5 were secondary to percutaneous transhepatic choleductus drainage （PTCD）,4 were secondary to percutaneous transhe-patic removal of bile duct stones,2 were secondary to open cholecystectomy,and 5 were secondary to other surgeries.CT showed localized or diffused hepatic subcapsular fluid collection with crescent-shaped or sac-shaped.The hepatic volume decreased and the surface was compressed in some of the cases with diffused fluid collection.Conclusion When localized or diffused hepatic subcapsular fluid collection was detected in CT imaging after liver or gallbladder surgeries （especially LC and PTCD）,HSB should be considered.Paracentesis should be performed as soon as possible.

关 键 词：肝包膜下胆汁瘤 计算机体层成像 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]