ERCP处理Caroli’s病合并胆道感染:1例案例报告和文献综述  

ERCP for treatment of Caroli's disease complicated with biliary infection:A case report and review of the literature

作　　者：梅剑锋 王征 张筱凤 陆磊 Jian-Feng Mei;Zheng Wang;Xiao-Feng Zhang;Lei Lu(Department of General Surgery,Lanxi People’s Hospital,Lanxi 321100,Zhejiang Province,China;Department of Gastroenterology,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]兰溪市人民医院普外科,浙江省兰溪市321100 [2]浙江大学医学院附属杭州市第一人民医院消化内科,浙江省杭州市310006

出　　处：《世界华人消化杂志》2019年第8期535-538,共4页World Chinese Journal of Digestology

摘　　要：背景 Caroli’s病是一种临床少见的先天性肝内胆管囊性扩张性疾病,继发肝内胆管结石和反复发作的胆管炎是该病的主要合并症,严重者可导致脓毒血症而危及生命.既往多采用外科手术的治疗方式,但是在急性感染期施行外科手术的并发症发生率和死亡率均较高.病例概述 1例中年男性患者因"腹痛伴畏寒、发热11h"来院就诊.患者11年前在外院确诊Caroli’s病,期间患者反复出现胆道感染,约6-10 mo发作一次,经保守治疗后好转.此次入院后先给予药物保守治疗,但患者的血象、体温未见明显好转.在保守治疗无效的情况下,我们成功施行了经内镜逆行性胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)下胆管取石术,患者痊愈后出院.结论对于内科保守治疗无效的Caroli’s病合并胆道感染者,ERCP不失为一种安全、可行、有效的处理方法.BACKGROUND Caroli’s disease is a rare congenital malformation characterized by saccular dilatation of intrahepatic bile ducts,with intrahepatic stones and recurrent cholangitis being its potential complications,which can lead to sepsis as a life-endangering complication.Surgery is mostly used for Caroli’s disease complicated with biliary infection;however,the morbidity and mortality of surgery are high during the acute infectious period.CASE SUMMARY A middle-age male patient presented with epigastric pain and fever for 11 h.He was diagnosed with Caroli’s disease 11 years ago,and he had acute biliary infection every 6 to 10 mo since then,which usually recovered after conservative treatments.Upon admission,he was initially given conservative treatment.However,he still had fever and acute biliary infection.We performed endoscopic retrograde cholangiopancreatography(ERCP)after failed conservative treatment,and the patient recovered uneventfully.CONCLUSION For patients with Caroli’s disease complicated with biliary infection who failed to conservative treatment,ERCP is a safe,feasible,and effective treatment method.

关 键 词：Caroli’s病 胆道感染 外科手术 经内镜逆行胰胆管造影术 案例报告 

分 类 号：R657.4[医药卫生—外科学]