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Gallefisteln und biliäre Stauung nach hepatopankreatobiliären Eingriffen

Biliary fistulas and biliary congestion after hepatopancreaticobiliary surgery

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Zusammenfassung

Biliäre Komplikationen nach hepatopankreatobiliären Eingriffen können schwerwiegende Folgen für die langfristige Lebensqualität unserer Patienten haben. Die adäquate und zeitgerechte Diagnose des vorliegenden Problems durch die klinische Beurteilung des erfahrenen Operateurs ist entscheidend. Sonographie, Computertomographie, Kontrastdarstellungen von Drainagen und endoskopisch retrograde Cholangiopankreatikographie (ERCP) sind die wegweisenden bildgebenden Verfahren, die vom erfahrenen Viszeralchirurgien schrittweise eingesetzt werden können. Die frühzeitige operative Revision ist das erste Mittel im direkt postoperativen Verlauf. Interventionelle Verfahren wie ERCP und perkutane transhepatische Cholangiodrainage (+ Stents und Drainagen) bieten eine Vielzahl weiterer Therapieoptionen, die maßgeschneidert interdisziplinär indiziert und vom geübten Interventionalisten angewandt werden sollen.

Abstract

Biliary complications after hepatopancreaticobiliary surgery can have severe consequences for the long-term quality of life of patients. Adequate and timely diagnosis of the underlying problem by an experienced surgeon is essential. Ultrasonography, computed tomography, contrast-enhanced fluoroscopy of drains and endoscopic retrograde cholangiopancreatography (ERCP) are helpful examinations that can be employed in a step-wise approach. Early re-do surgery is indicated in the initial postoperative course. Interventional methods, such as ERCP and percutaneous transhepatic cholangiodrainage ( PTCD, plus stents and drains) offer a variety of additional therapeutic options that should be used by the experienced interventionalist in a patient-tailored interdisciplinary fashion.

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Authors and Affiliations

  1. Klinik und Poliklinik für Chirurgie, Universitätsklinikum Regensburg, 93042, Regensburg, Deutschland

    M.-H. Dahlke Ph.D, M. Loss & H.J. Schlitt

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  1. M.-H. Dahlke Ph.D
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  2. M. Loss
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  3. H.J. Schlitt
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Correspondence to M.-H. Dahlke Ph.D.

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M.H. Dahlke, M. Loss und H.J. Schlitt geben an, dass kein Interessenskonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Dahlke, MH., Loss, M. & Schlitt, H. Gallefisteln und biliäre Stauung nach hepatopankreatobiliären Eingriffen. Chirurg 86, 547–551 (2015). https://doi.org/10.1007/s00104-015-0005-0

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  • DOI: https://doi.org/10.1007/s00104-015-0005-0

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