胆囊十二指肠瘘的诊断与治疗

Diagnosis and management of gallbladder-duodenal fistula

胆囊十二指肠瘘在临床上较少见,诊断困难,1例术前检查高度怀疑胆囊十二指肠瘘病人,因无法行手术治疗改行经皮肝穿刺胆囊引流(PTGD),根据PTGD管中引流出胃液和肠液最终确诊。在后期瘘口修复和病人营养支持治疗中,选择经皮经胆道置入空肠营养管路径,最终获得良好效果。

Gallbladder-duodenal fistula is a rare disease in clinical practice,and difficult to diagnosis.One patient with high suspicion of gallbladder-duodenal fistula in preoperative examination was performed with percutaneous transhepatic gallbladder drainage due to could not tolerate surgical operation,and gallbladder-duodenal fistula was diagnosed with the gastric and intestinal fluids extracted from the drainage tube.In the later of fistula repair and the patient′s nutritional support management,the jejunal nutrition tube is inserted through the bile duct,and then the nutrition support was performed through this jejunal nutrition tube.This patients was recovered well.