Pneumoperitoneum Caused by Air Leakage through the Percutaneous Puncture Tract as a Complication of Rendezvous Technique: A Case Report

對於內視鏡逆行性膽道攝影時膽管插管困難的患者，併用經皮穿肝膽道攝影與內視鏡會合技術是一有效與安全的解決方法。經皮穿刺程序與內視鏡程序可分兩階段進行，也可一階段接續完成。文獻報告若兩程序在一階段完成的併發症較少，住院時間也較短。在此我們報告一位接受一階段會合技術以取出總膽管結石，卻併發腹腔積氣的病例。因內視鏡過程中持續的灌氣，使腸道中高壓的空氣循著切開的乳突與經皮穿肝穿刺之路徑進入腹腔。據此，在會合技術結束拔除經皮穿肝膽道導管前，先將腸道中的空氣抽出應有助於減少此併發症。

關鍵字

內視鏡逆行性膽道攝影術；經皮穿肝膽道攝影術；腹腔積氣；會合技術

並列摘要

The rendezvous technique, combining percutaneous and endoscopic procedures, is a safe and effective method to achieve biliary cannulation if an endoscopic approach fails. The two procedures in this technique can be carried out simultaneously or in stages. A simultaneous approach is reported to be associated with fewer complications, and patients undergoing this approach can recover and be discharged more rapidly. Here, we report a complication of pneumoperitoneum in a patient who underwent percutaneous and endoscopic procedures simultaneously for the removal of a common bile duct stone. It was supposed that prolonged air insufflation during endoscopy forced intestinal air to track into the peritoneal cavity through the bile ducts and the puncture tract. Accordingly, a short wait before removing the percutaneous catheter to deflate the intestinal air will be helpful to avoid such a complication.

並列關鍵字

endoscopic retrograde cholangiography ； percutaneous transhepatic ； cholangiography ； pneumoperitoneum ； rendezvous technique

國際替代計量

Pneumoperitoneum Caused by Air Leakage through the Percutaneous Puncture Tract as a Complication of Rendezvous Technique: A Case Report

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