【摘要】 目的 探讨医源性肝包膜下胆汁瘤(HSB)的临床及CT表现。方法 收集本院资料齐全、经穿刺确诊的医源性HSB患者7例,检索文献报道的医源性HSB病例18例,对其临床及CT表现特点进行回顾性分析。结果 25例医源性HSB中,发生于腹腔镜胆囊切除术后9例,经皮经肝胆道引流术后5例,经皮经肝胆道取石术后4例,开腹胆囊切除术后2例,其他手术5例。CT表现为肝脏包膜下水样密度影,局限性或弥漫性分布,呈新月形或囊袋状,部分病例伴有肝脏体积缩小,肝表面受压凹陷。结论 肝胆手术,特别是腹腔镜及介入手术后,CT显示肝脏包膜下局限性或弥漫性积液,应考虑HSB可能,需及早穿刺确诊并置管引流。更多还原

【Abstract】 Objective To investigate the clinical and CT manifestations of iatrogenic hepatic subcapsular biloma(HSB).Methods Seven cases with iatrogenic HSB confirmed by paracentesis in our hospital,and 18 reported in literatures were enrolled into this study.Their clinical and CT manifestations were retrospectively analyzed.Results Of the 25 cases,9 were secondary to laparoscopic cholecystectomy(LC),5 were secondary to percutaneous transhepatic choleductus drainage(PTCD),4 were secondary to percutaneous transhepatic removal of bile duct stones,2 were secondary to open cholecystectomy,and 5 were secondary to other surgeries.CT showed localized or diffused hepatic subcapsular fluid collection with crescent-shaped or sac-shaped.The hepatic volume decreased and the surface was compressed in some of the cases with diffused fluid collection.Conclusion When localized or diffused hepatic subcapsular fluid collection was detected in CT imaging after liver or gallbladder surgeries(especially LC and PTCD),HSB should be considered Paracentesis should be performed as soon as possible.更多还原