總膽管十二指腸吻合手術在過去是常使用於治療膽道結石的手術方式。本篇報導一個接受這種手術方式的晚期併發症。這名65歲男性,在20年前因肝內及總膽管結石在外院接受多次手術,以總膽管十二指腸吻合手術為最終治療方式。四年後,患者因急性膽道炎而首次入院,經保守治療後出院。然而在過去這20年中,病患因反覆上行性膽道炎•肝膿瘍而多次住院,最後經由總膽管空腸吻合手術才得到症狀緩解。因此,我們建議總膽管十二指腸吻合手術,應避免使用在肝內結石。如因而出現症狀,應該早期採取手術方式來矯正。
Choledochoduodenstomy (CD) has been performed for hepatolithiasis in the past. However, it is rarely performed recenthy because of the frequenthy postoperative infection. We present a 65-year-old male who developed repeated ascending cholangitis and liver abscess after CD. Surgical conversion to Roux-en-Y choledochojejunostomy relieved the infection. We suggest that CD should be avoided in hepatolithiasis. If complications develop after CD, early surgical conversion is recommended.