Laparoscopic treatment of biliary peritonitis following nonoperative management of blunt liver trauma.
Fiche publication
Date publication
janvier 2010
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BACHELLIER Philippe, Pr PESSAUX Patrick
Tous les auteurs :
Marzano E, Rosso E, Oussoultzoglou E, Collange O, Bachellier P, Pessaux P
Lien Pubmed
Résumé
ABSTRACT: INTRODUCTION: Nonoperative management (NOM) of hemodynamically stable patients with blunt hepatic injuries is considered the current standard of care. However, it is associated with several in-hospital complications. In selected cases laparoscopy could be proposed as diagnostic and therapeutic means. CASE REPORT: A 28 years-old male was admitted in the Emergency Unit following a motor vehicle crash. CT-scan showed an isolated stade II hepatic injury at the level of the segment IV. Firstly a NOM was decided. Laparoscopic exploration was then performed at day 4 due to a biliary peritonitis. Intraoperative trans-cystic duct cholangiography showed a biliary leaks of left hepatic biliary tract, involving sectioral pedicle to segment III. Cholecystectomy, trans-cystic biliary drainage, application of surgical tissue sealing patch and abdominal drainage were performed. Postoperative outcome was uneventful, with fast patient recovery. CONCLUSION: Laparoscopy has gained a role as diagnostic and therapeutic means in treatment of complications following NOM of blunt liver trauma. This approach seems feasible and safety, with satisfactory postoperative outcome.
Référence
World J Emerg Surg. 2010 Sep 15;5:26.