Spontaneous Retroperitoneal Biloma: A Case Report

以經皮穿刺引流治療自發性後腹腔膽汁瘤－個案報告

謝賜吉(Tsyh-Jyi Hsieh) ； 蔣宜璋(I-Chan Chiang) ； 郭功楷(Kung-Kai Kuo) ； 劉金昌(Gin-Chung Liu) ； 郭禹廷(Yu-Ting Kuo)

《The Kaohsiung Journal of Medical Sciences》 18卷8期 (2002/08) Pp. 412-416

https://doi.org/10.6452/KJMS.200208.0412

摘要

我們報告一個以經皮穿刺引流治療自發性後腹腔膽汁瘤的罕見案例。一位74歲的男性患者因為背痛及全身無力來求診，在電腦斷層及超音波的檢查中，我們發現在患者的右側後腹腔有一個巨大的病灶，而在經皮抽吸後診斷為膽汁瘤。由於此男性患者的年齡太大，屬於手術麻醉高危險群，因此選擇先在超音波導引下，經皮穿刺放置引流管，作為膽汁的初步治療。然後再進行膽囊切除術及總膽管結石移除，術中並末發現肝外膽管有膽汁外流的情形。因此我們建議對高危險群的膽汁瘤患者，應考慮先以非開刀的方式治療。

關鍵字

經皮穿刺引流 ； 後腹腔 ； 膽汁瘤

並列摘要

We report a rare case of spontaneous rupture of the biliary tree with biloma in the retroperitoneum. A 74-year-old man was admitted with back pain and general weakness. Computerized tomography (CT) and sonography showed a huge lesion in the right retroperitoneuill, and a diagnosis of biloma was made after percutaneous aspiration. A percutaneous drainage catheter was initially inserted into the right retroperitoneal lesion under sonographic guidance to treat the biloma because of high surgical risk. When his general condition had improved, the patient underwent cholecystectomy and removal of . the common bile duct stone; there was no evidence of leakage in the extrahepatic bile duct. Non-surgical intervention before definitive biliary surgery is considered the first choice for treating bilomas in high-risk patients.

並列關鍵字

biloma ； retroperitoneum ； percutaneous drainage